code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
CDM,1501010,HB PHARMACY GENERAL,48.71,24.355,0.53,53.93,16
CDM,1501012,HB PHARMACY IV,57.83,28.915,15.0,39.6,16
CDM,1501014,HB PHARMACY HCPCS CODED,97.94,48.97,7.32,205.33,16
CDM,1501015,HB PHARMACY SELF ADMINISTERED,34.9,17.45,5.99,7154.13,16
CDM,1501016,HB PHARMACY C CODED,15060.18,7530.09,3765.05,9939.72,16
CDM,1702068,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",351.0,175.5,53.49,1286.64,31
CDM,1702099,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",263.0,131.5,78.9,357.68,31
CDM,1702100,"INJECTION, COSYNTROPIN, 0.25 MG",330.0,165.0,34.07,448.8,28
CDM,1702106,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.0,1.5,0.18,4.08,28
CDM,1702108,"Pneumococcal vaccine, 23-valent",261.0,130.5,26.68,354.96,32
CDM,1702124,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",54.0,27.0,0.76,73.44,28
CDM,1702126,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1595.0,797.5,281.79,2169.2,31
CDM,1702149,"Hepatitis B vaccine, adult dosage (3 dose schedule)",226.0,113.0,26.68,307.36,32
CDM,1702172,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",49.0,24.5,1.44,66.64,28
CDM,1702210,Hepatitis A and hepatitis B vaccine,404.0,202.0,121.2,549.44,32
CDM,1702211,Typhoid vaccine for injection into muscle,332.0,166.0,26.68,451.52,32
CDM,1702256,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",148.0,74.0,26.68,201.28,32
CDM,1702263,"Pneumococcal vaccine, 13-valent",565.0,282.5,141.24,768.4,32
CDM,1702282,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",71.0,35.5,21.3,128.98,31
CDM,1702308,"INJECTION, DAPTOMYCIN, 1 MG",4.0,2.0,0.05,5.44,28
CDM,1702319,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",404.0,202.0,26.68,549.44,32
CDM,1702321,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",661.0,330.5,141.24,898.96,32
CDM,1702322,"INJECTION, TILDRAKIZUMAB, 1 MG",449.0,224.5,134.7,9401.8,31
CDM,1720000,ROOM & BOARD - PRIVATE (ONE BED) - MEDICAL/SURGICAL/GYN,3350.0,1675.0,971.5,1842.5,11
CDM,1720001,ROOM & BOARD - PRIVATE (ONE BED) - OBSTETRICS (OB),3350.0,1675.0,971.5,1842.5,11
CDM,1720002,ROOM & BOARD - PRIVATE (ONE BED) - PEDIATRIC,3350.0,1675.0,971.5,1842.5,11
CDM,1720004,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - MEDICAL/SURGICAL/GYN,2565.0,1282.5,743.85,1410.75,11
CDM,1720005,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - OBSTETRICS (OB),2565.0,1282.5,743.85,1410.75,11
CDM,1720008,ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - PSYCHIATRIC,2565.0,1282.5,623.7,1395.36,17
CDM,1720009,NURSERY - NEWBORN - LEVEL II,4900.0,2450.0,1421.0,2695.0,11
CDM,1720010,NURSERY - NEWBORN - LEVEL I,3350.0,1675.0,971.5,1842.5,11
CDM,1720011,NURSERY - NEWBORN - LEVEL III,6980.0,3490.0,2024.2,3839.0,11
CDM,1720012,NURSERY - NEWBORN - LEVEL IV,10450.0,5225.0,3030.5,5747.5,11
CDM,1720013,INTENSIVE CARE UNIT - SURGICAL,6500.0,3250.0,1885.0,3575.0,11
CDM,1720014,INTENSIVE CARE UNIT - MEDICAL,6500.0,3250.0,1885.0,3575.0,11
CDM,1720015,INTENSIVE CARE UNIT - PEDIATRIC,6500.0,3250.0,1885.0,3575.0,11
CDM,1720016,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4235.0,2117.5,1228.15,2329.25,11
CDM,1720017,CORONARY CARE UNIT - GENERAL CLASSIFICATION,5500.0,2750.0,1595.0,3025.0,11
CDM,1720020,"HOSPITAL OBSERVATION SERVICE, PER HOUR",140.0,70.0,42.0,931.04,32
CDM,1720022,DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE,1905.0,952.5,571.5,2590.8,28
CDM,1720026,ROOM & BOARD - PRIVATE (ONE BED) - HOSPICE,3350.0,1675.0,971.5,1842.5,11
CDM,1720029,ROOM & BOARD - PRIVATE (ONE BED) - PSYCHIATRIC,2685.0,1342.5,623.7,1460.64,17
CDM,1720030,ROOM & BOARD - SEMI-PRIVATE - THREE AND FOUR BEDS - PSYCHIATRIC,2365.0,1182.5,623.7,1286.56,17
CDM,1720035,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4235.0,2117.5,1228.15,2329.25,11
CDM,2060000001,INTENSIVE CARE UNIT - INTERMEDIATE ICU,4235.0,2117.5,1228.15,2329.25,11
CDM,2090000001,INTENSIVE CARE UNIT - OTHER INTENSIVE CARE,6250.0,3125.0,1812.5,3437.5,11
CDM,2609636000,"Infusion into a vein for hydration, 31-60 minutes",663.0,331.5,198.9,901.68,32
CDM,2609636100,"Infusion into a vein for hydration, each additional hour",445.0,222.5,60.29,613.94,32
CDM,2609636500,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",950.0,475.0,273.88,1292.0,32
CDM,2609636600,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",545.0,272.5,60.29,741.2,32
CDM,2609636700,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",678.0,339.0,92.71,922.08,32
CDM,2609636800,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",526.0,263.0,157.8,715.36,32
CDM,2609637400,Injection of drug or substance into vein,528.0,264.0,58.14,718.08,32
CDM,2609637500,Injection of additional new drug or substance into vein,377.0,188.5,58.14,512.72,32
CDM,2609637600,Injection of additional drug or substance into vein provided in a facility,298.0,149.0,58.14,405.28,32
CDM,2700000002,HB VASHE WOUND SOLUTION,47.0,23.5,11.75,31.02,16
CDM,2700000004,HB THERAPEUTIC PLASMA EXCHANGE EACH ADDITIONAL CARTRIDGE,803.0,401.5,200.75,529.98,16
CDM,2700051,Incision of windpipe for insertion of breathing tube (older than 2 years),6516.0,3258.0,1954.8,8861.76,32
CDM,2700053,Creation of opening to throat for feeding,4225.0,2112.5,1267.5,5746.0,32
CDM,2700103,"Suture of simple wound, injury, or rupture of bladder",15905.0,7952.5,4771.5,21630.8,32
CDM,2700160,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",1953.0,976.5,570.27,2656.08,32
CDM,2700162,Removal with reinsertion of drug delivery implant into tissue,1738.0,869.0,207.21,2363.68,32
CDM,2700980,"CATHETER, DRAINAGE",1725.0,862.5,517.5,2346.0,28
CDM,2701033,"Insertion of tube into umbilical vein, newborn",802.0,401.0,94.28,1090.72,32
CDM,2701519,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",1191.0,595.5,357.3,1619.76,28
CDM,2701681,HB MARQUEE BARD NEEDLE,365.0,182.5,91.25,240.9,16
CDM,2701714,"TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",137.0,68.5,41.1,186.32,28
CDM,2701716,"TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",495.0,247.5,148.5,1088.88,27
CDM,2701836,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",249.0,124.5,74.7,338.64,28
CDM,2702104,Ultrasound scan of fetal brain artery blood flow rate,899.0,449.5,105.21,1222.64,32
CDM,2702107,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.0,3.0,0.25,8.16,28
CDM,2708121,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",5313.0,2656.5,1593.9,7225.68,32
CDM,2708384,Correction of rigid deformity of first joint of big toe,8847.0,4423.5,2654.1,12031.92,32
CDM,2708385,Correction of bunion,8847.0,4423.5,2654.1,12031.92,32
CDM,2708386,Correction of bunion with alignment correction of midfoot bone toward toe area,9091.0,4545.5,2727.3,12363.76,32
CDM,2709510,HB LACTATED RINGER 1000,110.0,55.0,27.5,72.6,16
CDM,2709511,HB NS 0.45 1000,110.0,55.0,27.5,72.6,16
CDM,2709513,HB NS 0.9 1000,110.0,55.0,27.5,72.6,16
CDM,2709516,HB NS 0.9 500,110.0,55.0,27.5,72.6,16
CDM,27100001,HB SPLY SURGICAL NON-STERILE,5354.64,2677.32,1338.66,3534.06,16
CDM,2720000001,HB DIALYSIS CARTRIDGE WITH FILTER,1255.0,627.5,313.75,828.3,16
CDM,2720000003,HB COBLATOR WAND,741.0,370.5,185.25,489.06,16
CDM,2720000006,HB CYTOLOGY BRUSH,244.0,122.0,61.0,161.04,16
CDM,2720000007,HB BIOPSY FORCEPS,212.0,106.0,53.0,139.92,16
CDM,2720000008,HB ENDOBRONCHIAL GUIDE/CHANNEL,4782.0,2391.0,1195.5,3156.12,16
CDM,2720000010,HB INFLATION SYRINGE,94.0,47.0,23.5,62.04,16
CDM,2720000011,HB GUIDE SHEATH,780.0,390.0,195.0,514.8,16
CDM,2720000012,HB PULMONARY PROBE,695.0,347.5,173.75,458.7,16
CDM,2720000013,HB PULMONARY NEEDLE,660.0,330.0,165.0,435.6,16
CDM,2720000014,HB PLEURAL DRAINAGE VACUUM BOTTLE,212.0,106.0,53.0,139.92,16
CDM,2720000015,HB FULGRATING ELECTRODE,306.0,153.0,76.5,201.96,16
CDM,2720000016,HB COLONIC TRANSIT CAPSULE WITH RADIO-OPAQUE MARKERS,317.0,158.5,79.25,209.22,16
CDM,2720000017,HB ECMO CARDIOPULMONARY BYPASS PUMP,33000.0,16500.0,8250.0,21780.0,16
CDM,27200001,HB SPLY SURGICAL STERILE,488.75,244.38,85.09,1089.47,16
CDM,27201052,"HEMOSTATIC AGENT, GASTROINTESTINAL, TOPICAL",3301.4849999999997,1650.74,904.5,4879.63,28
CDM,27201600,"CATHETER, TRANSLUMINAL INTRAVASCULAR LESION PREPARATION DEVICE, BLADED, SHEATHED (INSERTABLE)",8019.9,4009.95,2405.97,10907.06,27
CDM,2720160100,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), PULMONARY, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",4860.0,2430.0,1458.0,6609.6,27
CDM,27201603,"RETRIEVAL DEVICE, INSERTABLE, LASER (USED TO RETRIEVE INTRAVASCULAR INFERIOR VENA CAVA FILTER)",12274.55,6137.28,3682.37,16693.39,27
CDM,27201714,"CATHETER, TRANSLUMINAL ATHERECTOMY, DIRECTIONAL",12369.8,6184.9,3710.94,16822.93,28
CDM,2720171503,BRACHYTHERAPY NEEDLE,68.0,34.0,20.4,92.48,28
CDM,27201724,"CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL",10619.86,5309.93,2428.57,17876.52,28
CDM,27201725,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",932.24,466.12,193.47,1419.88,28
CDM,27201726,"CATHETER, BALLOON DILATATION, NON-VASCULAR",1878.0,939.0,155.87,6894.1,28
CDM,2720172600,"CATHETER, BALLOON DILATATION, NON-VASCULAR",1751.0,875.5,525.3,2381.36,28
CDM,2720172602,"CATHETER, BALLOON DILATATION, NON-VASCULAR",912.0,456.0,273.6,1240.32,28
CDM,27201727,"CATHETER, BALLOON TISSUE DISSECTOR, NON-VASCULAR (INSERTABLE)",805.05,402.53,241.52,1094.87,28
CDM,2720172801,"CATHETER, BRACHYTHERAPY SEED ADMINISTRATION",432.0,216.0,129.6,587.52,28
CDM,27201729,"CATHETER, DRAINAGE",511.33,255.67,62.77,781.48,28
CDM,2720172900,"CATHETER, DRAINAGE",1875.0,937.5,562.5,2550.0,28
CDM,27201730,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",2630.54,1315.2749999999999,335.05,4643.1,28
CDM,27201731,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (20 OR MORE ELECTRODES)",4081.31,2040.65,1224.39,5550.57,28
CDM,27201732,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",9245.72,4622.86,2773.72,12574.18,28
CDM,27201733,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, OTHER THAN COOL-TIP",14923.77,7461.89,149.11,28677.39,28
CDM,27201747,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), URINARY TRACT, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",10742.76,5371.38,3222.83,14610.16,28
CDM,27201748,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), UPPER GI, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",10478.0,5239.0,3143.4,14250.08,28
CDM,27201751,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",597.8,298.9,140.65,4911.98,28
CDM,2720175100,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",1191.0,595.5,357.3,1619.76,28
CDM,27201753,"CATHETER, INTRAVASCULAR ULTRASOUND",3745.9300000000003,1872.9650000000001,1206.0,5467.2,28
CDM,27201755,"CATHETER, INTRASPINAL",2052.125,1026.065,272.09,4348.33,28
CDM,27201757,"CATHETER, THROMBECTOMY/EMBOLECTOMY",10180.09,5090.05,683.2,20296.78,28
CDM,27201758,"CATHETER, URETERAL",74.775,37.39,18.21,120.82,28
CDM,27201759,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",6132.505,3066.25,231.22,17417.45,28
CDM,27201761,"CATHETER, TRANSLUMINAL INTRAVASCULAR LITHOTRIPSY, CORONARY",17907.0,8953.5,5372.1,24353.52,28
CDM,27201766,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",3474.8,1737.4,746.11,6179.66,28
CDM,27201769,GUIDE WIRE,373.37,186.68,73.06,1318.57,28
CDM,2720176900,GUIDE WIRE,369.0,184.5,110.7,501.84,28
CDM,27201773,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1521.705,760.8499999999999,577.01,11517.55,28
CDM,27201787,"PATIENT PROGRAMMER, NEUROSTIMULATOR",3339.97,1669.99,1001.99,4542.36,28
CDM,2720178700,"PATIENT PROGRAMMER, NEUROSTIMULATOR",608.0,304.0,182.4,826.88,28
CDM,27201830,POWERED BONE MARROW BIOPSY NEEDLE,4018.16,2009.08,320.42,9567.6,28
CDM,27201884,EMBOLIZATION PROTECTIVE SYSTEM,9800.21,4900.1050000000005,1327.65,20726.4,28
CDM,27201885,"CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER",11201.4,5600.7,3086.1,15233.9,28
CDM,27201886,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",7954.87,3977.43,1487.4,10739.07,28
CDM,2720188600,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",5392.0,2696.0,1617.6,7333.12,28
CDM,27201887,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",475.855,237.925,56.42,4190.98,28
CDM,2720188700,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",2251.0,1125.5,675.3,3061.36,28
CDM,27201889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4144.96,2072.48,1049.47,12849.56,28
CDM,2720188900,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4470.0,2235.0,1341.0,6079.2,28
CDM,2720188901,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1587.0,793.5,476.1,2158.32,28
CDM,2720188902,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4185.0,2092.5,1255.5,5691.6,28
CDM,27201892,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",472.485,236.245,63.09,1066.43,28
CDM,27201893,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY",797.83,398.91,239.35,1085.05,28
CDM,27201894,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",235.4,117.69999999999999,60.4,1108.87,28
CDM,27202596,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",12573.0,6286.5,3771.9,17099.28,28
CDM,27202618,"PROBE/NEEDLE, CRYOABLATION",7578.42,3789.21,403.52,10482.89,28
CDM,2720261800,"PROBE/NEEDLE, CRYOABLATION",1604.0,802.0,481.2,2181.44,28
CDM,27202623,"CATHETER, TRANSLUMINAL ANGIOPLASTY, DRUG-COATED, NON-LASER",5873.15,2936.57,1815.93,8232.24,28
CDM,27202627,"CATHETER, SUPRAPUBIC/CYSTOSCOPIC",8.32,4.16,2.5,11.32,28
CDM,27202628,"CATHETER, OCCLUSION",2368.46,1184.23,693.95,9987.36,28
CDM,2720262800,"CATHETER, OCCLUSION",1031.0,515.5,309.3,1402.16,28
CDM,2720262801,"CATHETER, OCCLUSION",1004.0,502.0,301.2,1365.44,28
CDM,27202629,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, LASER",12351.625,6175.8150000000005,3667.65,16626.68,28
CDM,27202630,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP",29747.7,14873.85,4071.76,63608.78,28
CDM,2720851200,"GELATIN CAPSULES OR EQUIVALENT, FOR USE WITH TRACHEOESOPHAGEAL VOICE PROSTHESIS, REPLACEMENT ONLY, PER 10",12.0,6.0,2.68,7.92,28
CDM,27208607,"INJECTABLE BULKING AGENT FOR VOCAL CORD MEDIALIZATION, 0.1 ML, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1422.08,711.04,52.81,938.57,28
CDM,27209610,"CATHETER, TRANSLUMINAL DRUG DELIVERY WITH OR WITHOUT ANGIOPLASTY, CORONARY, NON-LASER (INSERTABLE)",21526.5,10763.25,2367.92,29276.04,27
CDM,27400481,"MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",22631.4,11315.7,2489.45,24334.14,28
CDM,27400506,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",2713.5,1356.75,814.05,1790.91,28
CDM,27408509,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",1839.57,919.79,134.48,1214.12,28
CDM,27501605,"PACEMAKER, LEADLESS, DUAL CHAMBER (RIGHT ATRIAL AND RIGHT VENTRICULAR IMPLANTABLE COMPONENTS), RATE-RESPONSIVE, INCLUDING ALL NECESSARY COMPONENTS FOR IMPLANTATION",99296.0,49648.0,10922.56,135042.56,27
CDM,27501785,"PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",12513.95,6256.97,1376.53,17018.97,28
CDM,27501786,"PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",39257.21,19628.6,4318.29,53389.8,28
CDM,27501898,"LEAD, PACEMAKER, OTHER THAN TRANSVENOUS VDD SINGLE PASS",1641.63,820.815,491.05,2239.14,28
CDM,27502621,"PACEMAKER, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",22399.84,11199.92,2463.98,30463.78,28
CDM,27602630,ANTERIOR CHAMBER INTRAOCULAR LENS,405.65,202.83,121.7,267.73,28
CDM,27602632,POSTERIOR CHAMBER INTRAOCULAR LENS,640.18,320.09,145.73,422.52,28
CDM,27602787,ASTIGMATISM CORRECTING FUNCTION OF INTRAOCULAR LENS,1038.0,519.0,311.4,1411.68,28
CDM,27801602,"ORTHOPEDIC/DEVICE/DRUG MATRIX/ABSORBABLE BONE VOID FILLER, ANTIMICROBIAL-ELUTING (IMPLANTABLE)",24584.03,12292.01,2704.24,33434.27,27
CDM,27801713,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1597.24,798.62,346.41,5584.18,28
CDM,2780171700,"BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE",405.0,202.5,121.5,550.8,32
CDM,27801721,"CARDIOVERTER-DEFIBRILLATOR, DUAL CHAMBER (IMPLANTABLE)",42165.5,21082.75,4638.21,57345.08,28
CDM,27801722,"CARDIOVERTER-DEFIBRILLATOR, SINGLE CHAMBER (IMPLANTABLE)",37554.1,18777.05,4130.95,51073.58,28
CDM,27801729,"CATHETER, DRAINAGE",2055.13,1027.57,616.54,2794.98,28
CDM,27801734,ORTHOPEDIC/DEVICE/DRUG MATRIX FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO BONE (IMPLANTABLE),12466.32,6233.16,1371.3,16954.2,28
CDM,27801750,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",2279.52,1139.7649999999999,308.53,4801.64,28
CDM,27801752,"CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM",725.0,362.5,203.84,1462.82,28
CDM,27801760,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",947.09,473.54,284.13,1344.8,28
CDM,27801762,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",10585.59,5292.8,1164.42,14396.41,28
CDM,27801763,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",501.61,250.805,20.98,1284.74,28
CDM,27801764,"EVENT RECORDER, CARDIAC (IMPLANTABLE)",15948.6,7974.3,1739.27,21715.7,28
CDM,27801765,ADHESION BARRIER,1592.86,796.43,477.86,2166.28,28
CDM,27801767,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), NON-RECHARGEABLE",94168.09,47084.04,10358.49,128068.6,28
CDM,27801768,"GRAFT, VASCULAR",3289.58,1644.7849999999999,372.48,7259.06,28
CDM,27801771,"REPAIR DEVICE, URINARY, INCONTINENCE, WITH SLING GRAFT",5191.71,2595.86,1557.51,7060.73,28
CDM,27801772,"INFUSION PUMP, PROGRAMMABLE (IMPLANTABLE)",43135.89,21567.95,4744.95,58664.81,28
CDM,27801776,JOINT DEVICE (IMPLANTABLE),3216.605,1608.3,563.43,6716.64,28
CDM,27801777,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)",10545.39,5272.69,1159.99,14341.73,28
CDM,27801778,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",16405.08,8202.54,1804.56,22310.91,28
CDM,2780177800,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",138.0,69.0,41.4,187.68,28
CDM,27801781,MESH (IMPLANTABLE),5205.52,2602.76,1279.97,8719.15,28
CDM,27801783,"OCULAR IMPLANT, AQUEOUS DRAINAGE ASSIST DEVICE",6358.85,3179.42,1907.65,8648.03,28
CDM,27801784,"OCULAR DEVICE, INTRAOPERATIVE, DETACHED RETINA",195.55,97.77,58.66,265.94,28
CDM,27801788,"PORT, INDWELLING (IMPLANTABLE)",1439.51,719.755,369.25,2241.52,28
CDM,27801789,"PROSTHESIS, BREAST (IMPLANTABLE)",4456.79,2228.4,1337.04,6061.24,28
CDM,27801813,"PROSTHESIS, PENILE, INFLATABLE",37276.03,18638.01,4100.36,50695.4,28
CDM,27801814,"RETINAL TAMPONADE DEVICE, SILICONE OIL",1633.62,816.81,490.09,2221.72,28
CDM,27801815,"PROSTHESIS, URINARY SPHINCTER (IMPLANTABLE)",28125.36,14062.68,3093.79,38250.5,28
CDM,27801817,"SEPTAL DEFECT IMPLANT SYSTEM, INTRACARDIAC",28653.56,14326.785,3761.94,46511.28,28
CDM,27801819,SURGICAL TISSUE LOCALIZATION AND EXCISION DEVICE (IMPLANTABLE),117.19,58.59,35.16,159.37,28
CDM,27801820,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), WITH RECHARGEABLE BATTERY AND CHARGING SYSTEM",80045.45,40022.72,8805.0,108861.81,28
CDM,27801821,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),11750.7,5875.35,1292.58,15980.95,28
CDM,27801833,"MONITOR, CARDIAC, INCLUDING INTRACARDIAC LEAD AND ALL SYSTEM COMPONENTS (IMPLANTABLE)",6030.0,3015.0,1809.0,8200.8,28
CDM,27801874,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",11884.88,5942.44,603.3,18085.16,28
CDM,2780187400,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",7050.0,3525.0,2115.0,9588.0,28
CDM,27801876,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",6747.77,3373.89,1180.56,22589.94,28
CDM,27801880,VENA CAVA FILTER,3854.7250000000004,1927.365,1131.24,5677.11,28
CDM,27801882,"CARDIOVERTER-DEFIBRILLATOR, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",51548.33,25774.16,5670.32,70105.72,28
CDM,27801883,"ADAPTER/EXTENSION, PACING LEAD OR NEUROSTIMULATOR LEAD (IMPLANTABLE)",2554.18,1277.09,766.25,3473.68,28
CDM,27801888,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",7392.78,3696.39,1070.03,20985.48,28
CDM,27801889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5609.085,2804.54,102.55,50549.13,28
CDM,2780188901,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",11166.0,5583.0,1228.26,15185.76,28
CDM,27801896,"LEAD, CARDIOVERTER-DEFIBRILLATOR, OTHER THAN ENDOCARDIAL SINGLE OR DUAL COIL (IMPLANTABLE)",15601.95,7800.98,1716.21,21218.65,28
CDM,27801897,"LEAD, NEUROSTIMULATOR TEST KIT (IMPLANTABLE)",6034.4,3017.2,1810.32,8206.78,28
CDM,2780189700,"LEAD, NEUROSTIMULATOR TEST KIT (IMPLANTABLE)",274.0,137.0,82.2,372.64,28
CDM,27801899,"LEAD, PACEMAKER/CARDIOVERTER-DEFIBRILLATOR COMBINATION (IMPLANTABLE)",1921.5,960.75,576.45,2613.24,28
CDM,27801900,"LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM",6290.55,3145.28,1887.17,8555.15,28
CDM,27802007,"RESTRATA, PER SQUARE CENTIMETER",344.78,172.39,103.43,468.9,28
CDM,27802026,"RESTRATA MINIMATRIX, 5 MG",84.41,42.2,25.32,114.8,28
CDM,27802027,"MATRIDERM, PER SQUARE CENTIMETER",314.07,157.04,94.22,427.14,28
CDM,27802616,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",64995.55,32497.78,7149.51,88393.95,32
CDM,27802617,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",386.42,193.21,112.39,681.28,28
CDM,27802622,"PROSTHESIS, PENILE, NON-INFLATABLE",41555.27,20777.63,4571.08,56515.16,28
CDM,27802624,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",63175.0,31587.5,6949.25,85918.0,28
CDM,27802625,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",552.82,276.41,119.75,807.68,28
CDM,27802631,"REPAIR DEVICE, URINARY, INCONTINENCE, WITHOUT SLING GRAFT",3159.08,1579.54,947.72,4296.35,28
CDM,27802642,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",94117.86,47058.93,150.12,128000.29,32
CDM,27802790,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",3880.56,1940.28,1164.17,5277.56,28
CDM,27804104,"INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER",381.06,190.53,114.32,518.24,28
CDM,2780410400,"INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER",154.0,77.0,46.2,209.44,28
CDM,27804107,"GRAFTJACKET, PER SQUARE CENTIMETER",346.29,173.15,103.89,470.96,28
CDM,27804108,"INTEGRA MATRIX, PER SQUARE CENTIMETER",457.2,228.6,137.16,621.79,28
CDM,27804116,"ALLODERM, PER SQUARE CENTIMETER",116.07,58.04,34.82,160.23,28
CDM,27804118,"MATRISTEM MICROMATRIX, 1 MG",10.29,5.15,3.09,14.0,28
CDM,27804130,"STRATTICE TM, PER SQUARE CENTIMETER",106.36,53.18,31.91,160.23,28
CDM,27804148,"NEOX CORD 1K, NEOX CORD RT, OR CLARIX CORD 1K, PER SQUARE CENTIMETER",642.36,321.18,160.23,873.61,28
CDM,27804155,"NEOXFLO OR CLARIXFLO, 1 MG",46.23,23.12,13.87,62.87,28
CDM,27804156,"NEOX 100 OR CLARIX 100, PER SQUARE CENTIMETER",192.54,96.27,57.76,261.85,28
CDM,27804158,"KERECIS OMEGA3, PER SQUARE CENTIMETER",157.59,78.79,47.28,214.32,28
CDM,27804262,"TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH",413.66,206.83,124.1,562.57,28
CDM,27804263,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",435.54,217.77,130.66,592.33,28
CDM,2780426300,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",128.0,64.0,38.4,174.08,28
CDM,27804301,"IMPLANTABLE ACCESS TOTAL CATHETER, PORT/RESERVOIR (E.G., VENOUS, ARTERIAL, EPIDURAL, SUBARACHNOID, PERITONEAL, ETC.)",1692.21,846.11,507.66,2301.41,28
CDM,27804648,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",1964.2,982.1,105.54,9905.48,28
CDM,27808000,"SUPPORT DEVICE, EXTRAVASCULAR, FOR ARTERIOVENOUS FISTULA (IMPLANTABLE)",18669.0,9334.5,2053.59,25389.84,27
CDM,27808603,"INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",404.24,202.12,121.27,729.08,28
CDM,27808606,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",4221.0,2110.5,252.88,2785.86,28
CDM,2780860600,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",3543.0,1771.5,252.88,2338.38,28
CDM,27808610,OCULAR IMPLANT,623.47,311.74,187.04,1138.35,28
CDM,27808613,OSSICULA IMPLANT,1626.14,813.07,418.46,1073.25,28
CDM,27808614,"COCHLEAR DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS",60580.15,30290.07,6663.82,37438.53,28
CDM,27808690,"AUDITORY OSSEOINTEGRATED DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS",5936.8,2968.4,1781.04,7966.53,28
CDM,27808699,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",1161.6,580.8,348.48,1579.78,28
CDM,27811827,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), NON-RECHARGEABLE, WITH IMPLANTABLE STIMULATION LEAD AND EXTERNAL PAIRED STIMULATION CONTROLLER",106495.0,53247.5,11714.45,144833.2,28
CDM,27811889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",68731.045,34365.525,2434.98,121092.22,28
CDM,27812006,"NOVOSORB SYNPATH DERMAL MATRIX, PER SQUARE CENTIMETER",45.59,22.79,13.68,160.23,28
CDM,27821889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",61430.165,30715.085,6750.7,83626.85,28
CDM,27831889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",11134.0,5567.0,1224.74,15142.24,28
CDM,27841889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",45486.0,22743.0,5003.46,61860.96,28
CDM,27861889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",25399.97,12699.99,2794.0,34543.96,28
CDM,27871889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",82202.325,41101.165,1009.21,211112.8,28
CDM,27881889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",140790.0,70395.0,15486.9,191474.4,28
CDM,3000670,HB LAB HOLD,418.58500000000004,209.29000000000002,93.04,511.19,16
CDM,3001005,Puncture of skin for collection of blood sample,31.0,15.5,3.26,42.16,32
CDM,3003641500,Insertion of needle into vein for collection of blood sample,32.0,16.0,3.41,43.52,32
CDM,3003641600,Puncture of skin for collection of blood sample,31.0,15.5,3.26,42.16,32
CDM,3003659100,Collection of blood sample from implanted device,402.0,201.0,94.28,546.72,32
CDM,3003659200,Collection of blood sample from central venous tube,412.0,206.0,94.28,560.32,32
CDM,3003660000,Artery puncture collection of blood sample,150.0,75.0,45.0,204.0,32
CDM,3008105000,Urine volume measurement,35.0,17.5,1.27,47.6,32
CDM,3008110500,Gene analysis (Human Platelet Antigen 1) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008110600,Gene analysis (Human Platelet Antigen 2) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008110700,Gene analysis (Human Platelet Antigen 3) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008110800,Gene analysis (Human Platelet Antigen 4) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008110900,Gene analysis (Human Platelet Antigen 5) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008111000,Gene analysis (Human Platelet Antigen 6) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008111100,Gene analysis (Human Platelet Antigen 9) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008111200,Gene analysis (Human Platelet Antigen 15) for common variant,359.0,179.5,47.41,488.24,32
CDM,3008112000,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants",697.0,348.5,167.65,1346.95,32
CDM,3008112100,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",783.0,391.5,167.65,2316.04,32
CDM,3008116200,Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants,4500.0,2250.0,1440.0,82119.6,32
CDM,3008117000,"Gene analysis (ABL proto-oncogene 1, non-receptor tyrosine kinase)",1116.0,558.0,167.65,3348.0,32
CDM,3008120600,Translocation analysis (BCR/ABL1) major breakpoint,825.0,412.5,167.65,1352.67,32
CDM,3008120700,Translocation analysis (BCR/ABL1) minor breakpoint,819.0,409.5,167.65,1186.24,32
CDM,3008121000,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),632.0,316.0,167.65,1108.53,32
CDM,3008121900,"Gene analysis (calreticulin), common variants",701.0,350.5,47.41,953.36,32
CDM,3008122000,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,2004.0,1002.0,341.64,11154.26,32
CDM,3008122300,Gene analysis (cystic fibrosis transmembrane conductance regular) full gene sequence,1722.0,861.0,365.76,8592.78,32
CDM,3008122900,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,4669.0,2334.5,848.51,54160.4,32
CDM,3008123200,Gene analysis (dihydropyrimidine dehydrogenase) for common variant,612.0,306.0,167.65,1069.84,32
CDM,3008124000,"Gene analysis (prothrombin, coagulation factor II) A variant",692.0,346.0,47.41,941.12,32
CDM,3008124100,Gene analysis (coagulation factor V) Leiden variant,539.0,269.5,47.41,733.04,32
CDM,3008124300,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for detection of abnormal alleles",555.0,277.5,47.41,754.8,32
CDM,3008124500,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,749.0,374.5,167.65,1239.67,32
CDM,3008124600,Test for detecting genes associated with blood cancer,300.0,150.0,47.41,408.0,32
CDM,3008124900,Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis,2070.0,1035.0,621.0,12420.0,32
CDM,3008125600,Gene analysis (hemochromatosis) common variants,316.0,158.0,47.41,429.76,32
CDM,3008125700,Gene analysis (alpha globin 1 and alpha globin 2) for common deletions or variant,1027.0,513.5,47.41,1396.72,32
CDM,3008126100,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,973.0,486.5,167.65,1926.44,32
CDM,3008126400,Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect abnormal clonal population,696.0,348.0,167.65,1202.2,32
CDM,3008126500,Comparative analysis using Short Tandem Repeat (STR) markers of patient and specimen,1337.0,668.5,167.65,3116.15,32
CDM,3008126700,"Chimerism analysis post transplantation, without cell selection",1154.0,577.0,167.65,2394.09,32
CDM,3008126800,"Chimerism analysis post transplantation, with cell selection",967.0,483.5,167.65,2521.84,32
CDM,3008126900,Gene analysis (alpha globin 1 and alpha globin 2) for duplication/deletion variants,699.0,349.5,167.65,1414.78,32
CDM,3008127000,Gene analysis (Janus kinase 2) variant,863.0,431.5,47.41,1173.68,32
CDM,3008127300,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants",839.0,419.5,47.41,1141.04,32
CDM,3008127500,Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13,852.0,426.0,167.65,1646.49,32
CDM,3008127600,"Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants",483.0,241.5,154.56,933.4,32
CDM,3008127800,Gene analysis (IGH@/BCL2 (t(14;18)) translocation analysis,759.0,379.5,167.65,1573.48,32
CDM,3008127900,Gene analysis (Janus kinase 2) targeted sequence analysis,802.0,401.0,167.65,1485.3,32
CDM,3008129100,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",406.0,203.0,47.41,552.16,32
CDM,3008130100,Microsatellite instability analysis,796.0,398.0,167.65,2774.54,32
CDM,3008131000,Gene analysis (nucleophosmin) exon 12 variants,888.0,444.0,167.65,2189.1,32
CDM,3008131100,Gene analysis for cancer (neuroblastoma),1006.0,503.0,167.65,2975.65,32
CDM,3008131500,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,662.0,331.0,167.65,1372.39,32
CDM,3008132900,"Gene analysis (survival of motor neuron 1, telomeric) for dosage/deletion",494.0,247.0,148.2,676.78,32
CDM,3008133500,Gene analysis (thiopurine S-methyltransferase) for common variant,648.0,324.0,167.65,1132.77,32
CDM,3008133800,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) for detection of common variants",519.0,259.5,155.7,780.21,32
CDM,3008133900,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) sequence analysis of exon 10",636.0,318.0,167.65,1177.87,32
CDM,3008134000,Gene analysis (T cell antigen receptor beta) amplification methodology,2231.0,1115.5,167.65,4661.01,32
CDM,3008136400,"Gene analysis (hemoglobin, subunit beta) full sequence analysis",1745.0,872.5,167.65,5663.92,32
CDM,3008137000,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",1491.0,745.5,365.76,5995.61,32
CDM,3008137200,HLA class I typing low resolution,1019.0,509.5,326.08,4112.58,32
CDM,3008137300,HLA class I typing low resolution one locus,933.0,466.5,47.41,1268.88,32
CDM,3008137400,"HLA class I typing, low resolution one antigen equivalent",829.0,414.5,47.41,1127.44,32
CDM,3008137600,HLA class II typing low resolution one locus,884.0,442.0,47.41,1202.24,32
CDM,3008137700,HLA class II typing low resolution one antigen equivalent,933.0,466.5,47.41,1268.88,32
CDM,3008137800,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1",1281.0,640.5,167.65,4426.75,32
CDM,3008138000,HLA class I typing high resolution one locus,812.0,406.0,167.65,1439.27,32
CDM,3008138100,HLA class I typing high resolution one allele or allele group,518.0,259.0,165.76,880.08,32
CDM,3008138200,HLA class II typing high resolution one locus,632.0,316.0,47.41,859.52,32
CDM,3008140106,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,32
CDM,3008140107,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,32
CDM,3008140108,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,32
CDM,3008140122,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,32
CDM,3008140123,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,32
CDM,3008140301,Molecular pathology procedure level 4 genetic analysis,1238.0,619.0,167.65,2292.78,32
CDM,3008140304,Molecular pathology procedure level 4 genetic analysis,1238.0,619.0,167.65,2292.78,32
CDM,3008140305,Molecular pathology procedure level 4 genetic analysis,1238.0,619.0,167.65,2292.78,32
CDM,3008140306,Molecular pathology procedure level 4 genetic analysis,1238.0,619.0,167.65,2292.78,32
CDM,3008140600,Molecular pathology procedure level 7 genetic analysis,4144.0,2072.0,167.65,11722.55,32
CDM,3008140801,Molecular pathology procedure level 9 genetic analysis,4600.0,2300.0,821.94,92000.0,32
CDM,3008142000,"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel",2734.0,1367.0,667.43,20752.43,32
CDM,3008144301,Genomic sequence analysis panel for severe inherited conditions with sequencing of 15 or more genes,2853.0,1426.5,855.9,69857.42,32
CDM,3008145001,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,3134.0,1567.0,667.43,23803.67,32
CDM,3008145002,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,3134.0,1567.0,667.43,23803.67,32
CDM,3008147902,Molecular pathology procedure,494.0,247.0,0.5,671.84,32
CDM,3008147907,Molecular pathology procedure,416.0,208.0,0.5,565.76,32
CDM,3008147912,Molecular pathology procedure,416.0,208.0,0.5,565.76,32
CDM,3008147919,Molecular pathology procedure,416.0,208.0,0.5,565.76,32
CDM,3008147926,Molecular pathology procedure,416.0,208.0,0.5,565.76,32
CDM,3008147928,Molecular pathology procedure,416.0,208.0,0.5,565.76,32
CDM,3008151400,Measurement of DNA of bacteria in vaginal fluid specimen,395.0,197.5,118.5,1038.81,32
CDM,3008159600,Biochemical assays for evaluation of chronic Hepatitis C virus infection,291.0,145.5,47.41,395.76,32
CDM,3008303300,Fetal hemoglobin analysis,28.0,14.0,2.24,38.08,32
CDM,3008363100,Stool lactoferrin (immune system protein) level,448.0,224.0,12.17,609.28,32
CDM,3008387600,Myeloperoxidase (white blood cell enzyme) measurement,184.0,92.0,15.29,250.24,32
CDM,3008411200,Cervicovaginal secretion of placenta protein,311.0,155.5,69.31,422.96,32
CDM,3008414000,Pregnenolone (reproductive hormone) level,224.0,112.0,13.43,304.64,32
CDM,3008420200,Protoporphyrin (metabolism substance) level,51.0,25.5,7.32,69.36,32
CDM,3008500900,Manual white blood cell count and evaluation,81.0,40.5,4.11,110.16,32
CDM,3008504400,"Red blood count, manual test",72.0,36.0,3.1,97.92,32
CDM,3008530600,Protein S (clotting inhibitor) measurement,285.0,142.5,4.51,387.6,32
CDM,3008605100,ELISA detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,238.0,119.0,11.72,323.68,32
CDM,3008605300,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,130.0,65.0,39.0,176.8,32
CDM,3008615601,Measurement of cold agglutinin (protein) to screen for infection or disease,214.0,107.0,8.16,291.04,32
CDM,3008636300,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,130.0,65.0,39.0,176.8,32
CDM,3008636301,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,130.0,65.0,39.0,176.8,32
CDM,3008638100,Measurement of mitochondrial antibody,155.0,77.5,11.72,210.8,32
CDM,3008659600,Measurement of voltage-gated calcium channel antibody,315.0,157.5,11.72,428.4,32
CDM,3008664100,Analysis for antibody to Cryptococcus (yeast),142.0,71.0,11.72,193.12,32
CDM,3008666300,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",94.0,47.0,11.72,127.84,32
CDM,3008671100,Analysis for antibody to john cunningham virus,3401.0,1700.5,11.72,4625.36,32
CDM,3008672000,Analysis for antibody to Leptospira,124.0,62.0,11.72,168.64,32
CDM,3008675700,Analysis for antibody to Rickettsia (bacteria),68.0,34.0,11.72,92.48,32
CDM,3008692000,"Blood unit compatibility test, immediate spin technique",567.0,283.5,19.37,771.12,32
CDM,3008722000,Tissue fungi or parasites,86.0,43.0,3.67,116.96,32
CDM,3008725500,Virus isolation,130.0,65.0,40.78,176.8,32
CDM,3008733700,Detection test by immunoassay technique for Entamoeba histolytica group (parasite),121.0,60.5,10.73,164.56,32
CDM,3008747600,"Detection by nucleic acid for borrelia burgdorferi (bacteria), amplified probe technique",325.0,162.5,41.79,442.0,32
CDM,3008748300,Test for detecting nucleic acid of organism causing infection of central nervous system,719.0,359.5,23.44,2996.65,32
CDM,3008750700,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets",1182.0,591.0,207.57,4926.34,32
CDM,3008753800,"Detection test by nucleic acid for HIV-2 virus, amplified probe technique",106.0,53.0,37.2,144.16,32
CDM,3008756300,Detection of Mycoplasma genitalium by DNA or RNA probe,122.0,61.0,36.6,165.92,32
CDM,3008759300,Detection of orthopoxvirus,193.0,96.5,43.62,262.48,32
CDM,3008762500,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",146.0,73.0,43.62,198.56,32
CDM,3008763200,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 6-11 targets",809.0,404.5,207.57,1764.11,32
CDM,3008763300,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 12-25 targets",1072.0,536.0,207.57,4467.88,32
CDM,3008763700,"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus",514.0,257.0,43.62,733.12,64
CDM,3008765300,"Detection test by nucleic acid for Strep (Streptococcus, group B), amplified probe technique",122.0,61.0,39.04,165.92,32
CDM,3008922000,Sputum specimen collection,561.0,280.5,21.41,762.96,32
CDM,3008923000,Sweat collection,414.0,207.0,10.36,563.04,32
CDM,3009900001,Handling and/or conveyance of specimen for transfer from physician office to laboratory,25.0,12.5,3.43,34.0,32
CDM,3010010300,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),168.0,84.0,11.72,228.48,32
CDM,3018004700,"Blood test, basic group of blood chemicals (Calcium, ionized)",186.0,93.0,9.19,252.96,32
CDM,3018004800,"Blood test, basic group of blood chemicals (Calcium, total)",120.0,60.0,9.19,163.2,32
CDM,3018005000,General health panel,446.0,223.0,9.19,606.56,32
CDM,3018005100,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",86.0,43.0,6.03,116.96,32
CDM,3018005300,"Blood test, comprehensive group of blood chemicals",245.0,122.5,9.19,333.2,32
CDM,3018006100,"Blood test, lipids (cholesterol and triglycerides)",169.0,84.5,9.19,229.84,32
CDM,3018006900,Kidney function blood test panel,147.0,73.5,9.19,199.92,32
CDM,3018007400,Acute hepatitis panel,510.0,255.0,9.19,693.6,32
CDM,3018007600,Liver function blood test panel,140.0,70.0,9.19,190.4,32
CDM,3018014300,Measurement of acetaminophen,190.0,95.0,12.35,258.4,32
CDM,3018014500,Measurement of adalimumab,544.0,272.0,12.35,739.84,32
CDM,3018015000,Amikacin (antibiotic) level,94.0,47.0,12.35,127.84,32
CDM,3018015600,"Carbamazepine level, total",153.0,76.5,12.35,208.08,32
CDM,3018015800,Cyclosporine level,219.0,109.5,12.35,297.84,32
CDM,3018015900,Clozapine level,121.0,60.5,12.35,164.56,32
CDM,3018016100,"Measurement of carbamazepine-10,11-epoxide",188.0,94.0,12.35,255.68,32
CDM,3018016200,"Digoxin level, total",113.0,56.5,12.35,153.68,32
CDM,3018016400,"Valproic acid level, total",118.0,59.0,12.35,160.48,32
CDM,3018016500,"Valproic acid level, free",300.0,150.0,12.35,408.0,32
CDM,3018016700,Measurement of felbamate,430.0,215.0,12.35,584.8,32
CDM,3018016800,Ethosuximide level,67.0,33.5,10.95,91.12,32
CDM,3018016900,Everolimus level,224.0,112.0,12.35,304.64,32
CDM,3018017000,Gentamicin (antibiotic) level,139.0,69.5,12.35,189.04,32
CDM,3018017100,Gabapentin level,173.0,86.5,12.35,235.28,32
CDM,3018017500,Lamotrigine level,193.0,96.5,12.35,262.48,32
CDM,3018017600,Lidocaine level,60.0,30.0,8.81,81.6,32
CDM,3018017700,Levetiracetam level,193.0,96.5,12.35,262.48,32
CDM,3018017800,Lithium level,69.0,34.5,4.56,93.84,32
CDM,3018017900,Measurement of salicylate,167.0,83.5,12.35,227.12,32
CDM,3018018000,Mycophenolate (mycophenolic acid) level,40.0,20.0,7.22,64.98,32
CDM,3018018300,Oxcarbazepine level,193.0,96.5,12.35,262.48,32
CDM,3018018400,Phenobarbital level,98.0,49.0,12.35,133.28,32
CDM,3018018500,"Phenytoin level, total",146.0,73.0,12.35,198.56,32
CDM,3018018600,"Phenytoin level, free",155.0,77.5,12.35,210.8,32
CDM,3018018800,Primidone level,104.0,52.0,12.35,141.44,32
CDM,3018018900,Measurement of itraconazole,415.0,207.5,12.35,564.4,32
CDM,3018019300,Measurement of leflunomide,307.0,153.5,12.35,417.52,32
CDM,3018019500,Sirolimus level,164.0,82.0,12.35,223.04,32
CDM,3018019700,Tacrolimus level,251.0,125.5,12.35,341.36,32
CDM,3018019800,Theophylline level,52.0,26.0,7.35,70.72,32
CDM,3018020000,Tobramycin (antibiotic) level,107.0,53.5,12.35,145.52,32
CDM,3018020100,Topiramate level,44.0,22.0,5.24,59.84,32
CDM,3018020200,Vancomycin (antibiotic) level,128.0,64.0,12.35,174.08,32
CDM,3018020300,Zonisamide level,193.0,96.5,12.35,262.48,32
CDM,3018020400,Measurement of methotrexate,200.0,100.0,12.35,272.0,32
CDM,3018022000,Measurement of hydroxychloroquine,64.0,32.0,11.93,87.04,32
CDM,3018023000,Measurement of infliximab,544.0,272.0,12.35,739.84,32
CDM,3018023500,Measurement of lacosamide,109.0,54.5,12.35,148.24,32
CDM,3018028000,Measurement of vedolizumab,421.0,210.5,12.35,572.56,32
CDM,3018028500,Measurement of voriconazole,109.0,54.5,12.35,148.24,32
CDM,3018029900,Quantitation of therapeutic drug,220.0,110.0,12.35,299.2,32
CDM,3018029902,Quantitation of therapeutic drug,280.0,140.0,12.35,380.8,32
CDM,3018029903,Measurement of adalimumab,280.0,140.0,12.35,380.8,32
CDM,3018030701,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030702,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030706,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030708,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030711,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030718,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030724,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018030725,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,32
CDM,3018032000,Alcohols levels,165.0,82.5,14.24,224.4,30
CDM,3018032100,"Alcohols levels, 1 or 2",412.0,206.0,14.24,560.32,30
CDM,3018032300,Alkaloids levels,62.0,31.0,14.24,84.32,30
CDM,3018033500,"Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)",51.0,25.5,14.24,69.36,30
CDM,3018033502,"Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)",51.0,25.5,14.24,69.36,30
CDM,3018033503,"Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)",51.0,25.5,14.24,69.36,30
CDM,3018033504,"Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)",51.0,25.5,14.24,69.36,30
CDM,3018033904,"Antiepileptics levels, 1-3",218.0,109.0,17.32,296.48,30
CDM,3018034600,"Benzodiazepines levels, 1-12",56.0,28.0,14.24,76.16,30
CDM,3018034604,"Benzodiazepines levels, 1-12",56.0,28.0,14.24,76.16,30
CDM,3018034900,"Cannabinoids levels, natural",101.0,50.5,14.24,137.36,30
CDM,3018035400,Fentanyl level,419.0,209.5,14.24,569.84,30
CDM,3018035600,Heroin metabolite level,123.0,61.5,14.24,167.28,30
CDM,3018036100,Opiates levels,175.0,87.5,14.24,238.0,30
CDM,3018036500,Oxycodone levels,175.0,87.5,14.24,238.0,30
CDM,3018037503,"Drugs or substances measurement, 1-3",80.0,40.0,24.0,108.8,30
CDM,3018037700,"Drugs or substances measurement, 7 or more",275.0,137.5,14.24,374.0,30
CDM,3018040800,Aldosterone suppression evaluation panel,440.0,220.0,35.6,598.4,32
CDM,3018201000,"Ketone bodies analysis, quantitative",137.0,68.5,5.5,186.32,32
CDM,3018201002,"Ketone bodies analysis, quantitative",137.0,68.5,5.5,186.32,32
CDM,3018201700,Chemical test for genetic disorder,69.0,34.5,11.64,93.84,32
CDM,3018202400,Adrenocorticotropic hormone (ACTH) level,140.0,70.0,35.6,190.4,32
CDM,3018204000,Albumin (protein) level,49.0,24.5,2.43,66.64,32
CDM,3018204200,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",29.0,14.5,2.26,39.44,32
CDM,3018204300,Urine microalbumin (protein) level,94.0,47.0,3.06,127.84,32
CDM,3018207700,Measurement of alcohol level in specimen other than breath or urine,154.0,77.0,14.24,209.44,32
CDM,3018208500,Aldolase (enzyme) level,35.0,17.5,3.4,47.6,32
CDM,3018208800,Aldosterone hormone level,148.0,74.0,35.6,201.28,32
CDM,3018210300,"Alpha-1-antitrypsin (protein) blood test, total",56.0,28.0,7.53,76.16,32
CDM,3018210400,"Alpha-1-antitrypsin (protein) blood test, phenotype",180.0,90.0,12.17,244.8,32
CDM,3018210500,"Alpha-fetoprotein (AFP) level, serum",161.0,80.5,12.17,218.96,32
CDM,3018210600,"Alpha-fetoprotein (AFP) level, amniotic fluid",62.0,31.0,10.54,84.32,32
CDM,3018210700,Alpha-fetoprotein (AFP) analysis,293.0,146.5,28.66,398.48,32
CDM,3018210800,Aluminum level,99.0,49.5,12.53,134.64,32
CDM,3018213100,"Amino acid analysis, quantitative, each specimen",344.0,172.0,12.17,467.84,32
CDM,3018213900,"Amino acid level, 6 or more amino acids, quantitative, each specimen",821.0,410.5,12.17,1116.56,32
CDM,3018214000,Ammonia level,54.0,27.0,7.87,73.44,32
CDM,3018215000,Amylase (enzyme) level,99.0,49.5,5.5,134.64,32
CDM,3018215700,Androstenedione (hormone) level,106.0,53.0,13.43,144.16,32
CDM,3018216400,Angiotensin l - converting enzyme (ACE) level,54.0,27.0,7.88,73.44,32
CDM,3018216600,Test for anti-mullerian hormone,281.0,140.5,84.3,382.16,28
CDM,3018217200,Apolipoprotein level,77.0,38.5,12.17,104.72,32
CDM,3018217201,Apolipoprotein level,77.0,38.5,12.17,104.72,32
CDM,3018217500,Arsenic level,113.0,56.5,12.53,153.68,32
CDM,3018218000,"Ascorbic acid (Vitamin C) level, blood",138.0,69.0,5.5,187.68,32
CDM,3018223200,Beta-2 microglobulin (protein) level,135.0,67.5,13.43,183.6,32
CDM,3018223900,"Bile acids level, total",66.0,33.0,11.3,89.76,32
CDM,3018224700,"Bilirubin level, total",49.0,24.5,2.46,66.64,32
CDM,3018224800,"Bilirubin level, direct",49.0,24.5,2.46,66.64,32
CDM,3018226100,Biotinidase (enzyme) level,62.0,31.0,10.46,84.32,32
CDM,3018227000,Stool analysis for blood to screen for colon tumors,43.0,21.5,1.88,58.48,32
CDM,3018227200,"Stool analysis for blood, by peroxidase activity",51.0,25.5,2.16,69.36,32
CDM,3018230000,Cadmium level,142.0,71.0,12.53,193.12,32
CDM,3018230600,Vitamin D-3 level,160.0,80.0,28.66,217.6,32
CDM,3018230800,Calcitonin (hormone) level,108.0,54.0,13.43,146.88,32
CDM,3018231000,"Calcium level, total",63.0,31.5,3.25,85.68,32
CDM,3018233000,"Calcium level, ionized",80.0,40.0,10.94,108.8,32
CDM,3018234000,Urine calcium level,68.0,34.0,4.1,92.48,32
CDM,3018236500,Infrared analysis of stone,47.0,23.5,6.06,63.92,32
CDM,3018237300,Carbohydrate deficient transferrin (protein) level,66.0,33.0,11.92,89.76,32
CDM,3018237400,Carbon dioxide (bicarbonate) level,49.0,24.5,2.39,66.64,32
CDM,3018237500,Carboxyhemoglobin (protein) level,50.0,25.0,6.16,68.0,32
CDM,3018237800,Carcinoembryonic antigen (CEA) protein level,206.0,103.0,12.17,280.16,32
CDM,3018237900,Carnitine level,62.0,31.0,10.46,84.32,32
CDM,3018238000,Carotene level,83.0,41.5,5.5,112.88,32
CDM,3018238400,Catecholamines (organic nitrogen) level,92.0,46.0,13.43,125.12,32
CDM,3018239000,Ceruloplasmin (protein) level,40.0,20.0,4.3,54.4,32
CDM,3018239700,Analysis using chemiluminescent technique (light and chemical )reaction,58.0,29.0,8.19,78.88,32
CDM,3018239701,Analysis using chemiluminescent technique (light and chemical )reaction,58.0,29.0,8.19,78.88,32
CDM,3018243500,Blood chloride level,48.0,24.0,2.21,65.28,32
CDM,3018243600,Urine chloride level,23.0,11.5,1.32,31.28,32
CDM,3018243800,Chloride level,28.0,14.0,1.4,38.08,32
CDM,3018246500,Cholesterol level,71.0,35.5,3.09,96.56,32
CDM,3018249500,Chromium level to test for poisoning or deficiency,106.0,53.0,12.53,144.16,32
CDM,3018250700,Citrate level,113.0,56.5,15.29,153.68,32
CDM,3018252300,"Collagen cross links test, (urine test to evaluate bone health)",68.0,34.0,12.17,92.48,32
CDM,3018252500,Copper level,63.0,31.5,7.82,85.68,32
CDM,3018253000,"Cortisol (hormone) measurement, free",68.0,34.0,11.36,92.48,32
CDM,3018253300,"Cortisol (hormone) measurement, total",146.0,73.0,13.43,198.56,32
CDM,3018254200,Chemical analysis using chromatography technique,98.0,49.0,12.17,133.28,32
CDM,3018254201,Chemical analysis using chromatography technique,98.0,49.0,12.17,133.28,32
CDM,3018254202,Chemical analysis using chromatography technique,98.0,49.0,12.17,133.28,32
CDM,3018254205,Chemical analysis using chromatography technique,140.0,70.0,12.17,190.4,32
CDM,3018254214,Chemical analysis using chromatography technique,98.0,49.0,12.17,133.28,32
CDM,3018254215,Chemical analysis using chromatography technique,98.0,49.0,12.17,133.28,32
CDM,3018255000,"Creatine kinase (cardiac enzyme) level, total",65.0,32.5,4.23,88.4,32
CDM,3018255200,"Creatine kinase (cardiac enzyme) level, isoenzymes",138.0,69.0,12.17,187.68,32
CDM,3018255300,"Creatine kinase (cardiac enzyme) level, MB fraction only",191.0,95.5,12.17,259.76,32
CDM,3018256500,Blood creatinine level,70.0,35.0,3.58,95.2,32
CDM,3018257000,Creatinine level to test for kidney function or muscle injury,89.0,44.5,4.61,121.04,32
CDM,3018257500,Creatinine clearance measurement to test for kidney function,158.0,79.0,5.5,214.88,32
CDM,3018259500,Cryoglobulin (protein) measurement,25.0,12.5,1.62,34.0,32
CDM,3018260700,Cyanocobalamin (vitamin B-12) level,162.0,81.0,13.43,220.32,32
CDM,3018261000,Cystatin C (enzyme inhibitor) level,68.0,34.0,12.17,92.48,32
CDM,3018261500,Cystine and homocystine (amino acids) analysis,272.0,136.0,5.5,369.92,32
CDM,3018262600,Dehydroepiandrosterone (DHEA) hormone level,92.0,46.0,12.17,125.12,32
CDM,3018262700,Dehydroepiandrosterone (DHEA-S) hormone level,129.0,64.5,13.43,175.44,32
CDM,3018263300,"Desoxycorticosterone, 11 (hormone) level",113.0,56.5,32.63,153.68,32
CDM,3018263400,"Deoxycortisol, 11 (hormone) level",146.0,73.0,13.43,198.56,32
CDM,3018264200,Measurement of dihydrotestosterone,106.0,53.0,13.43,144.16,32
CDM,3018265200,"Dihydroxyvitamin D, 1, 25 level",155.0,77.5,28.66,210.8,32
CDM,3018265300,Measurement of pancreatic elastase (enzyme) in stool,500.0,250.0,12.17,680.0,32
CDM,3018265700,"Enzyme activity measurement, nonradioactive substrate",382.0,191.0,12.17,519.52,32
CDM,3018265701,"Enzyme activity measurement, nonradioactive substrate",382.0,191.0,12.17,519.52,32
CDM,3018265702,"Enzyme activity measurement, nonradioactive substrate",382.0,191.0,12.17,519.52,32
CDM,3018266800,Erythropoietin (protein) level,233.0,116.5,12.17,316.88,32
CDM,3018267000,Measurement of total estradiol (hormone),187.0,93.5,13.43,254.32,32
CDM,3018267200,"Estrogen analysis, total",79.0,39.5,13.43,107.44,32
CDM,3018267700,Estriol (hormone) level,98.0,49.0,13.25,133.28,32
CDM,3018267900,Estrone (hormone) level,91.0,45.5,13.43,123.76,32
CDM,3018269300,Ethylene glycol (antifreeze) measurement,61.0,30.5,9.09,82.96,32
CDM,3018270500,"Stool fat or lipids analysis, qualitative",21.0,10.5,1.07,28.56,32
CDM,3018271000,"Stool fat or lipids analysis, quantitative",178.0,89.0,12.17,242.08,32
CDM,3018272600,Very long chain fatty acids level,539.0,269.5,12.17,733.04,32
CDM,3018272800,Ferritin (blood protein) level,146.0,73.0,12.17,198.56,32
CDM,3018273100,Fetal fibronectin (protein) analysis,375.0,187.5,63.21,510.0,32
CDM,3018274600,"Folic acid level, serum",157.0,78.5,12.17,213.52,32
CDM,3018274700,"Folic acid level, RBC",54.0,27.0,9.53,73.44,32
CDM,3018277500,Galactose-1-phosphate uridyl transferase (enzyme) level,74.0,37.0,12.17,100.64,32
CDM,3018277600,Galactose-1-phosphate uridyl transferase screening test,105.0,52.5,7.14,142.8,32
CDM,3018278400,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,32
CDM,3018278403,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,32
CDM,3018278405,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,32
CDM,3018278406,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,32
CDM,3018278408,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,32
CDM,3018278500,IgE (immune system protein) level,96.0,48.0,12.17,130.56,32
CDM,3018278700,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",137.0,68.5,5.5,186.32,32
CDM,3018280000,Blood pH level,92.0,46.0,8.16,125.12,32
CDM,3018280300,Blood gases measurement,230.0,115.0,28.66,312.8,32
CDM,3018280500,"Blood gases measurement, with O2 saturation",285.0,142.5,68.3,387.6,32
CDM,3018281000,"Blood gas, oxygen saturation measurement",58.0,29.0,5.5,78.88,32
CDM,3018294100,Gastrin (GI tract hormone) level,64.0,32.0,11.28,87.04,32
CDM,3018294300,Glucagon (pancreatic hormone) level,59.0,29.5,8.43,80.24,32
CDM,3018294500,Glucose (sugar) level on body fluid,67.0,33.5,2.63,91.12,32
CDM,3018294700,Blood glucose (sugar) level,60.0,30.0,2.36,81.6,32
CDM,3018295000,Blood glucose (sugar) level after receiving dose of glucose,91.0,45.5,4.32,123.76,32
CDM,3018295100,"Blood glucose (sugar) tolerance test, 3 specimens",128.0,64.0,12.17,174.08,32
CDM,3018295200,"Blood glucose (sugar) tolerance test, each additional beyond 3 specimens",39.0,19.5,1.53,53.04,32
CDM,3018295500,G6PD (enzyme) level,30.0,15.0,2.91,40.8,32
CDM,3018296200,Blood glucose (sugar) test performed by hand-held instrument,39.0,19.5,1.28,53.04,32
CDM,3018297700,Glutamyltransferase (liver enzyme) level,67.0,33.5,4.82,91.12,32
CDM,3018298501,Glycated protein level,61.0,30.5,10.22,82.96,32
CDM,3018300100,"Gonadotropin, follicle stimulating (reproductive hormone) level",189.0,94.5,13.43,257.04,32
CDM,3018300101,"Gonadotropin, follicle stimulating (reproductive hormone) level",189.0,94.5,13.43,257.04,32
CDM,3018300200,"Gonadotropin, luteinizing (reproductive hormone) level",189.0,94.5,13.43,257.04,32
CDM,3018300300,Human growth hormone level,61.0,30.5,10.17,82.96,32
CDM,3018301000,Haptoglobin (serum protein) level,129.0,64.5,12.17,175.44,32
CDM,3018301300,Breath test analysis for helicobacter pylori,244.0,122.0,69.31,331.84,32
CDM,3018301800,Heavy metal level,210.0,105.0,12.53,285.6,32
CDM,3018302000,"Hemoglobin analysis and measurement, electrophoresis",207.0,103.5,12.17,281.52,32
CDM,3018303600,Hemoglobin A1C level,105.0,52.5,5.5,142.8,32
CDM,3018305000,"Methemoglobin (hemoglobin) analysis, quantitative",40.0,20.0,3.28,54.4,32
CDM,3018305100,Plasma hemoglobin level,93.0,46.5,5.5,126.48,32
CDM,3018308800,Histamine (immune system substance) level,120.0,60.0,28.66,163.2,32
CDM,3018309000,Homocysteine (amino acid) level,197.0,98.5,13.43,267.92,32
CDM,3018315000,Homovanillic acid (organic acid) level,82.0,41.0,13.43,111.52,32
CDM,3018349700,Hydroxyindolacetic acid (product of metabolism) level,47.0,23.5,6.06,63.92,32
CDM,3018349800,"Hydroxyprogesterone, 17-D (synthetic hormone) level",151.0,75.5,13.43,205.36,32
CDM,3018351600,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351604,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351611,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351614,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351615,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351617,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,32
CDM,3018351902,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351905,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351907,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351913,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351914,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351915,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351924,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351928,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018351936,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,32
CDM,3018352000,Measurement of substance using immunoassay technique,360.0,180.0,12.17,489.6,32
CDM,3018352005,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352006,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352016,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352018,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352026,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352030,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352031,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352033,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352034,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352037,Measurement of substance using immunoassay technique,155.0,77.5,12.17,210.8,32
CDM,3018352100,Measurement of immunoglobulin light chains,171.0,85.5,12.17,232.56,32
CDM,3018352500,"Insulin measurement, total",47.0,23.5,5.37,63.92,32
CDM,3018352900,Measurement of interleukin-6,238.0,119.0,12.17,323.68,32
CDM,3018354000,Iron level,97.0,48.5,5.5,131.92,32
CDM,3018355000,Iron binding capacity,114.0,57.0,5.5,155.04,32
CDM,3018360500,Lactic acid level,36.0,18.0,4.17,48.96,32
CDM,3018361500,Lactate dehydrogenase (enzyme) level,62.0,31.0,3.74,84.32,32
CDM,3018362500,Lactate dehydrogenase (enzyme) measurement,70.0,35.0,8.95,95.2,32
CDM,3018365500,Lead level,70.0,35.0,8.48,95.2,32
CDM,3018369000,Lipase (fat enzyme) level,106.0,53.0,5.5,144.16,32
CDM,3018369500,Lipoprotein (A) level,53.0,26.5,7.59,72.08,32
CDM,3018370400,"Lipoprotein level, quantitation of lipoprotein particle number(s)",181.0,90.5,28.66,246.16,32
CDM,3018371800,HDL cholesterol level,113.0,56.5,5.5,153.68,32
CDM,3018372100,LDL cholesterol level,80.0,40.0,5.5,108.8,32
CDM,3018373500,Magnesium level,43.0,21.5,2.88,58.48,32
CDM,3018378500,Manganese (heavy metal) level,97.0,48.5,12.53,131.92,32
CDM,3018378905,Mass spectrometry (laboratory testing method),312.0,156.0,12.17,424.32,32
CDM,3018378908,Mass spectrometry (laboratory testing method),312.0,156.0,12.17,424.32,32
CDM,3018378909,Mass spectrometry (laboratory testing method),312.0,156.0,12.17,424.32,32
CDM,3018382500,Mercury level,66.0,33.0,10.73,89.76,32
CDM,3018383500,Metanephrines level,62.0,31.0,10.5,84.32,32
CDM,3018387300,"Myelin basic protein (nerve protein) level, spinal fluid",63.0,31.5,10.84,85.68,32
CDM,3018387400,Myoglobin (muscle protein) level,135.0,67.5,12.17,183.6,32
CDM,3018388000,Natriuretic peptide (heart and blood vessel protein) level,206.0,103.0,28.66,280.16,32
CDM,3018388300,"Nephelometry, test method using light",113.0,56.5,11.72,153.68,32
CDM,3018391600,Measurement of immune substance (oligoclonal bands),110.0,55.0,23.44,149.6,32
CDM,3018391800,Organic acids level,285.0,142.5,12.53,387.6,32
CDM,3018391900,Organic acids analysis,381.0,190.5,12.17,518.16,32
CDM,3018392100,Organic acid level,86.0,43.0,12.17,116.96,32
CDM,3018393000,Blood osmolality (concentration) measurement,99.0,49.5,5.5,134.64,32
CDM,3018393500,Urine osmolality (concentration) measurement,90.0,45.0,5.5,122.4,32
CDM,3018393700,Osteocalcin (bone protein) level,108.0,54.0,32.24,146.88,32
CDM,3018394500,Oxalate level,136.0,68.0,12.17,184.96,32
CDM,3018395100,Oncoprotein (cancer related gene) measurement,233.0,116.5,28.66,316.88,32
CDM,3018397000,Parathormone (parathyroid hormone) level,338.0,169.0,35.6,459.68,32
CDM,3018398600,Body fluid pH level,79.0,39.5,2.83,107.44,32
CDM,3018398601,Body fluid pH level,79.0,39.5,2.83,107.44,32
CDM,3018399300,Stool calprotectin (protein) level,72.0,36.0,12.17,97.92,32
CDM,3018403000,"Phenylalanine, PKU (amino acid) level",75.0,37.5,4.13,102.0,32
CDM,3018407500,"Phosphatase (enzyme) level, alkaline",59.0,29.5,3.06,80.24,32
CDM,3018408000,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",54.0,27.0,7.98,73.44,32
CDM,3018410000,Phosphate level,44.0,22.0,2.09,59.84,32
CDM,3018410500,Urine phosphate level,85.0,42.5,4.91,115.6,32
CDM,3018411000,Urine porphobilinogen (metabolism substance) level,88.0,44.0,5.5,119.68,32
CDM,3018412000,Urine porphyrins (metabolism substance) measurement,140.0,70.0,12.17,190.4,32
CDM,3018413200,Blood potassium level,60.0,30.0,2.86,81.6,32
CDM,3018413300,Urine potassium level,54.0,27.0,2.55,73.44,32
CDM,3018413400,Prealbumin (protein) level,113.0,56.5,12.17,153.68,32
CDM,3018414300,17-hydroxypregnenolone (hormone) level,280.0,140.0,13.43,380.8,32
CDM,3018414400,Progesterone (reproductive hormone) level,193.0,96.5,13.43,262.48,32
CDM,3018414500,Procalcitonin (hormone) level,118.0,59.0,13.43,160.48,32
CDM,3018414600,Prolactin (milk producing hormone) level,211.0,105.5,13.43,286.96,32
CDM,3018415300,"PSA (prostate specific antigen) measurement, total",191.0,95.5,12.17,259.76,32
CDM,3018415400,"PSA (prostate specific antigen) measurement, free",196.0,98.0,12.17,266.56,32
CDM,3018415500,"Total protein level, blood",49.0,24.5,1.8,66.64,32
CDM,3018415600,"Total protein level, urine",57.0,28.5,2.09,77.52,32
CDM,3018415700,"Total protein level, body fluid",50.0,25.0,2.0,68.0,32
CDM,3018416500,"Protein measurement, serum",224.0,112.0,5.5,304.64,32
CDM,3018416600,"Protein measurement, body fluid",187.0,93.5,12.17,254.32,32
CDM,3018418100,Protein measurement,262.0,131.0,11.72,356.32,32
CDM,3018418200,"Protein measurement, immunological probe for band identification",381.0,190.5,34.67,518.16,32
CDM,3018420600,Proinsulin (pancreatic hormone) level,97.0,48.5,13.43,131.92,32
CDM,3018420700,Vitamin B-6 level,102.0,51.0,28.66,138.72,32
CDM,3018421000,Pyruvate (organic acid) level,53.0,26.5,7.67,72.08,32
CDM,3018423803,Chemical receptor analysis,133.0,66.5,28.66,180.88,32
CDM,3018424400,Renin (kidney enzyme) level,80.0,40.0,13.43,108.8,32
CDM,3018425500,Selenium (vitamin) level,104.0,52.0,12.53,141.44,32
CDM,3018426000,Serotonin (hormone) level,262.0,131.0,35.6,356.32,32
CDM,3018427000,Sex hormone binding globulin (protein) level,89.0,44.5,12.17,121.04,32
CDM,3018429500,Blood sodium level,56.0,28.0,2.69,76.16,32
CDM,3018430000,Urine sodium level,22.0,11.0,1.11,29.92,32
CDM,3018430200,Sodium level,21.0,10.5,1.02,28.56,32
CDM,3018430201,Sodium level,21.0,10.5,1.02,28.56,32
CDM,3018430500,Somatomedin (growth factor) level,135.0,67.5,13.43,183.6,32
CDM,3018431100,Chemical analysis using spectrophotometry (light),126.0,63.0,5.5,171.36,32
CDM,3018431101,Chemical analysis using spectrophotometry (light),126.0,63.0,5.5,171.36,32
CDM,3018431102,Chemical analysis using spectrophotometry (light),126.0,63.0,5.5,171.36,32
CDM,3018431500,Specific gravity (liquid weight) measurement,32.0,16.0,1.05,43.52,32
CDM,3018437600,"Carbohydrate analysis, single qualitative",23.0,11.5,1.27,31.28,32
CDM,3018437700,"Carbohydrate analysis, multiple qualitative",23.0,11.5,1.27,31.28,32
CDM,3018439200,Urine sulfate (acid) level,158.0,79.0,3.06,214.88,32
CDM,3018440200,"Testosterone (hormone) level, free",146.0,73.0,13.43,198.56,32
CDM,3018440300,"Testosterone (hormone) level, total",199.0,99.5,13.43,270.64,32
CDM,3018441000,Testosterone level,177.0,88.5,35.6,240.72,32
CDM,3018442500,Vitamin B-1 (thiamine) level,86.0,43.0,12.17,116.96,32
CDM,3018443200,Thyroglobulin (thyroid related hormone) level,159.0,79.5,13.43,216.24,32
CDM,3018443300,Evaluation of thiopurine S-methyltransferase (TPMT),300.0,150.0,12.17,408.0,32
CDM,3018443600,"Thyroxine (thyroid chemical), total",105.0,52.5,7.21,142.8,32
CDM,3018443700,"Thyroxine (thyroid chemical), requiring elution",265.0,132.5,8.16,360.4,32
CDM,3018443900,"Thyroxine (thyroid chemical), free",114.0,57.0,10.28,155.04,32
CDM,3018444200,Thyroxine binding globulin (thyroid related protein) level,54.0,27.0,7.98,73.44,32
CDM,3018444300,"Blood test, thyroid stimulating hormone (TSH)",159.0,79.5,13.43,216.24,32
CDM,3018444500,Thyroid stimulating immune globulins (thyroid related protein) level,184.0,92.0,35.6,250.24,32
CDM,3018444600,Vitamin E level,52.0,26.0,7.37,70.72,32
CDM,3018444900,Transcortin (cortisol binding protein) level,131.0,65.5,13.43,178.16,32
CDM,3018445000,"Liver enzyme (SGOT), level",53.0,26.5,2.75,72.08,32
CDM,3018446000,"Liver enzyme (SGPT), level",56.0,28.0,2.97,76.16,32
CDM,3018446600,Transferrin (iron binding protein) level,95.0,47.5,12.12,129.2,32
CDM,3018447800,Triglycerides level,61.0,30.5,3.5,82.96,32
CDM,3018447900,Thyroid hormone evaluation,60.0,30.0,3.88,81.6,32
CDM,3018448000,"Thyroid hormone, T3 measurement, total",123.0,61.5,13.43,167.28,32
CDM,3018448100,"Thyroid hormone, T3 measurement, free",152.0,76.0,13.25,206.72,32
CDM,3018448200,"Thyroid hormone, T3 measurement, reverse",58.0,29.0,9.14,78.88,32
CDM,3018448400,"Troponin (protein) analysis, quantitative",130.0,65.0,12.17,176.8,32
CDM,3018452000,"Urea nitrogen level to assess kidney function, quantitative",40.0,20.0,1.58,54.4,32
CDM,3018454000,"Urea nitrogen level to assess kidney function, urine",60.0,30.0,3.34,81.6,32
CDM,3018455000,"Uric acid level, blood",79.0,39.5,3.57,107.44,32
CDM,3018456000,Uric acid level,74.0,37.0,3.76,100.64,32
CDM,3018458500,Urine vanillylmandelic acid,57.0,28.5,8.84,77.52,32
CDM,3018458600,Vasoactive intestinal peptide (intestinal hormone) level,143.0,71.5,35.6,194.48,32
CDM,3018458800,ADH (antidiuretic hormone) level,219.0,109.5,33.64,297.84,32
CDM,3018459000,Vitamin A level,43.0,21.5,4.99,58.48,32
CDM,3018459101,Vitamin measurement,69.0,34.5,11.77,93.84,32
CDM,3018459102,Vitamin measurement,69.0,34.5,11.77,93.84,32
CDM,3018459700,Vitamin K level,143.0,71.5,12.17,194.48,32
CDM,3018460000,Volatile chemical measurement,278.0,139.0,12.17,378.08,32
CDM,3018463000,Zinc level,42.0,21.0,4.78,57.12,32
CDM,3018468100,C-peptide (protein) level,76.0,38.0,12.17,103.36,32
CDM,3018470200,"Gonadotropin, chorionic (reproductive hormone) level",186.0,93.0,13.43,252.96,32
CDM,3018470300,Gonadotropin (reproductive hormone) analysis,86.0,43.0,5.5,116.96,32
CDM,3018499900,Chemistry procedures,171.0,85.5,0.5,232.56,32
CDM,3018499905,Chemistry procedures,171.0,85.5,0.5,232.56,32
CDM,3018601500,Measurement of Actin (smooth muscle) antibody,93.0,46.5,11.21,126.48,32
CDM,3018603600,Screening test for antineutrophil cytoplasmic antibody,206.0,103.0,11.72,280.16,32
CDM,3018636400,Measurement of tissue transglutaminase,255.0,127.5,11.72,346.8,32
CDM,3028600100,"Measurement of antibody (IgG) to allergic substance, each allergen",52.0,26.0,4.07,70.72,32
CDM,3028600300,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",41.0,20.5,2.14,55.76,32
CDM,3028600800,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",239.0,119.5,11.72,325.04,32
CDM,3028602100,Antibody identification test for white blood cell antibodies,228.0,114.0,11.72,310.08,32
CDM,3028602200,"Antibody identification test, platelet antibodies",76.0,38.0,11.72,103.36,32
CDM,3028602203,"Antibody identification test, platelet antibodies",76.0,38.0,11.72,103.36,32
CDM,3028603700,Antineutrophil cytoplasmic antibody titer,86.0,43.0,10.36,116.96,32
CDM,3028603800,Screening test for autoimmune disorder,102.0,51.0,11.72,138.72,32
CDM,3028603900,"Measurement of antibody for assessment of autoimmune disorder, titer",106.0,53.0,11.72,144.16,32
CDM,3028604100,Test for acetylcholine receptor binding antibody,343.0,171.5,59.8,466.48,28
CDM,3028604200,Test for acetylcholine receptor blocking antibody,298.0,149.0,54.83,405.28,28
CDM,3028604300,Test for acetylcholine receptor modulating antibody,310.0,155.0,37.36,421.6,28
CDM,3028606000,Measurement for Strep antibody (strep throat),27.0,13.5,1.97,36.72,32
CDM,3028614000,Measurement C-reactive protein for detection of infection or inflammation,85.0,42.5,4.4,115.6,32
CDM,3028614100,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",106.0,53.0,11.72,144.16,32
CDM,3028614600,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,78.0,39.0,11.72,106.08,32
CDM,3028614700,Cardiolipin antibody (tissue antibody) measurement,103.0,51.5,11.72,144.61,32
CDM,3028614800,Phospholipid antibody (autoimmune antibody) measurement,675.0,337.5,11.72,918.0,32
CDM,3028616000,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616001,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616002,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616003,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616004,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616005,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616007,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,32
CDM,3028616100,Measurement of complement function (immune system proteins),48.0,24.0,5.76,65.28,32
CDM,3028616200,"Measurement of complement (immune system proteins), total hemolytic",129.0,64.5,11.72,175.44,32
CDM,3028620000,Measurement of antibody for rheumatoid arthritis assessment,48.0,24.0,6.22,65.28,32
CDM,3028621500,Measurement of DNA antibody,54.0,27.0,7.16,73.44,32
CDM,3028622500,"Measurement of DNA antibody, native or double stranded",137.0,68.5,11.72,186.32,32
CDM,3028623100,Detection of endomysial antibody (EMA),347.0,173.5,11.72,471.92,32
CDM,3028623500,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623501,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623502,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623503,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623504,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623506,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623508,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623509,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623510,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623511,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623513,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028623514,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,32
CDM,3028625500,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625502,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625506,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625507,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625511,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625515,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625516,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625518,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,32
CDM,3028625600,Measurement of antibody to noninfectious agent,69.0,34.5,8.31,93.84,32
CDM,3028625800,Detection of gliadin (deamidated) (DGP) antibody,148.0,74.0,11.72,201.28,32
CDM,3028630000,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",184.0,92.0,11.72,250.24,32
CDM,3028630100,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",76.0,38.0,11.72,103.36,32
CDM,3028630400,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",250.0,125.0,11.72,340.0,32
CDM,3028630500,Analysis of female reproductive genetic marker,442.0,221.0,11.72,601.12,32
CDM,3028630800,Screening test for mononucleosis (mono),130.0,65.0,6.73,176.8,32
CDM,3028631600,Analysis for detection of tumor marker,140.0,70.0,11.72,190.4,32
CDM,3028631601,Analysis for detection of tumor marker,140.0,70.0,11.72,190.4,32
CDM,3028631602,Analysis for detection of tumor marker,140.0,70.0,11.72,190.4,32
CDM,3028631701,"Detection of infectious agent antibody, quantitative",98.0,49.0,11.72,133.28,32
CDM,3028631702,"Detection of infectious agent antibody, quantitative",98.0,49.0,11.72,133.28,32
CDM,3028631704,"Detection of infectious agent antibody, quantitative",98.0,49.0,11.72,133.28,32
CDM,3028633103,Immunologic analysis for detection of antigen or antibody,952.0,476.0,11.72,1294.72,32
CDM,3028633200,Immune complex measurement,165.0,82.5,11.72,224.4,32
CDM,3028633400,Immunologic analysis technique on serum (immunofixation),314.0,157.0,11.72,427.04,32
CDM,3028633500,"Immunologic analysis technique on body fluid, other fluids with concentration",340.0,170.0,34.67,462.4,32
CDM,3028633600,Inhibin A (reproductive organ hormone) measurement,57.0,28.5,8.89,77.52,32
CDM,3028633700,Insulin antibody measurement,86.0,43.0,11.72,116.96,32
CDM,3028634000,Intrinsic factor (stomach protein) antibody measurement,55.0,27.5,8.29,74.8,32
CDM,3028634100,Islet cell (pancreas) antibody measurement,86.0,43.0,11.72,116.96,32
CDM,3028635200,Analysis of cell function and analysis for genetic marker,684.0,342.0,41.55,930.24,32
CDM,3028635500,Total cell count for B cells (white blood cells),176.0,88.0,41.55,239.36,32
CDM,3028635700,Total cell count for natural killer cells (white blood cell),202.0,101.0,41.55,274.72,32
CDM,3028635900,"T cells count, total",210.0,105.0,41.55,285.6,32
CDM,3028636000,"T cell count and ratio, including ratio",336.0,168.0,41.55,456.96,32
CDM,3028636100,T cell count and ratio,275.0,137.5,16.31,374.0,32
CDM,3028636600,Test for muscle-specific kinase antibody,343.0,171.5,59.8,466.48,28
CDM,3028636700,"Stem cells count, total",355.0,177.5,41.55,482.8,32
CDM,3028637600,Microsomal antibodies (autoantibody) measurement,135.0,67.5,11.72,183.6,32
CDM,3028637601,Microsomal antibodies (autoantibody) measurement,135.0,67.5,11.72,183.6,32
CDM,3028637604,Microsomal antibodies (autoantibody) measurement,135.0,67.5,11.72,183.6,32
CDM,3028643100,Rheumatoid factor level,70.0,35.0,3.97,95.2,32
CDM,3028648000,"Tuberculosis test, gamma interferon",224.0,112.0,41.55,304.64,32
CDM,3028659200,Syphilis detection test,65.0,32.5,2.78,88.4,32
CDM,3028659300,Syphilis test,73.0,36.5,3.21,99.28,32
CDM,3028660200,Analysis for antibody to actinomyces (bacteria),70.0,35.0,7.13,95.2,32
CDM,3028660600,Analysis for antibody to aspergillus (fungus),71.0,35.5,10.69,96.56,32
CDM,3028660902,Analysis for antibody bacteria,151.0,75.5,11.72,205.36,32
CDM,3028661100,Analysis for antibody to Bartonella (bacteria),53.0,26.5,5.4,72.08,32
CDM,3028661200,Analysis for antibody to blastomyces (fungus),78.0,39.0,10.06,106.08,32
CDM,3028661700,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),188.0,94.0,11.72,255.68,32
CDM,3028661800,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),93.0,46.5,11.72,126.48,32
CDM,3028662200,Analysis for antibody to Brucella (bacteria),70.0,35.0,6.25,95.2,32
CDM,3028663100,Analysis for antibody to Chlamydia (bacteria),83.0,41.5,9.81,112.88,32
CDM,3028663200,Analysis for antibody (IgM) to Chlamydia (bacteria),464.0,232.0,11.72,631.04,32
CDM,3028663500,Analysis for antibody to Coccidioides (bacteria),255.0,127.5,11.72,346.8,32
CDM,3028663800,Analysis for antibody to Coxiella burnetii (Q fever bacteria),101.0,50.5,11.72,137.36,32
CDM,3028664400,Analysis for antibody to Cytomegalovirus (CMV),162.0,81.0,11.72,220.32,32
CDM,3028664500,Analysis for antibody (IgM) to Cytomegalovirus (CMV),92.0,46.0,11.72,125.12,32
CDM,3028665100,Analysis for antibody to La crosse (California) virus (encephalitis causing virus),341.0,170.5,11.72,463.76,32
CDM,3028665200,Analysis for antibody to Eastern equine virus (viral encephalitis),46.0,23.0,6.07,62.56,32
CDM,3028665300,Analysis for antibody to St. Louis virus (viral encephalitis),46.0,23.0,6.07,62.56,32
CDM,3028665400,Analysis for antibody to Western equine virus (viral encephalitis),46.0,23.0,6.07,62.56,32
CDM,3028665804,Analysis for antibody to Enterovirus (gastrointestinal virus),96.0,48.0,11.72,130.56,32
CDM,3028666400,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",138.0,69.0,11.72,187.68,32
CDM,3028666500,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",107.0,53.5,11.72,145.52,32
CDM,3028666600,Analysis for antibody to Ehrlichia (bacteria transmitted by ticks),36.0,18.0,3.66,48.96,32
CDM,3028667100,Analysis for antibody to fungus,65.0,32.5,7.96,88.4,32
CDM,3028667102,Analysis for antibody to fungus,65.0,32.5,7.96,88.4,32
CDM,3028667103,Analysis for antibody to fungus,65.0,32.5,7.96,88.4,32
CDM,3028668204,Analysis for antibody to helminth (intestinal worm),53.0,26.5,6.9,72.08,32
CDM,3028668205,Analysis for antibody to helminth (intestinal worm),53.0,26.5,6.9,72.08,32
CDM,3028668700,"Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)",79.0,39.5,7.18,107.44,32
CDM,3028668800,"Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)",89.0,44.5,11.72,121.04,32
CDM,3028669200,Analysis for antibody to Hepatitis D virus,70.0,35.0,11.72,95.2,32
CDM,3028669500,"Analysis for antibody to Herpes simplex virus, type 1",96.0,48.0,11.72,130.56,32
CDM,3028669600,"Analysis for antibody to Herpes simplex virus, type 2",110.0,55.0,11.72,149.6,32
CDM,3028669800,Analysis for antibody to histoplasma (fungus),51.0,25.5,7.03,69.36,32
CDM,3028670100,Analysis for antibody to HIV -1 virus,118.0,59.0,10.49,160.48,32
CDM,3028670200,Analysis for antibody to HIV-2 virus,103.0,51.5,11.72,140.08,32
CDM,3028670300,Analysis for antibody to HIV-1 and HIV-2 virus,135.0,67.5,11.72,183.6,32
CDM,3028670400,Hepatitis B core antibody measurement,134.0,67.0,11.72,182.24,32
CDM,3028670500,Hepatitis B core antibody (IgM) measurement,132.0,66.0,11.72,179.52,32
CDM,3028670600,Hepatitis B surface antibody measurement,149.0,74.5,11.72,202.64,32
CDM,3028670700,Hepatitis Be antibody measurement,43.0,21.5,4.98,58.48,32
CDM,3028670800,Measurement of Hepatitis A antibody,227.0,113.5,11.72,308.72,32
CDM,3028670900,Measurement of Hepatitis A antibody (IgM),126.0,63.0,11.72,171.36,32
CDM,3028673500,Analysis for antibody to mumps virus,90.0,45.0,11.72,122.4,32
CDM,3028673800,Analysis for antibody to Mycoplasma (bacteria),123.0,61.5,11.72,167.28,32
CDM,3028674700,Analysis for antibody to parvovirus,106.0,53.0,11.72,144.16,32
CDM,3028675301,Analysis for antibody to protozoa (parasite),92.0,46.0,11.4,125.12,32
CDM,3028675303,Analysis for antibody to protozoa (parasite),92.0,46.0,11.4,125.12,32
CDM,3028675304,Analysis for antibody to protozoa (parasite),92.0,46.0,11.4,125.12,32
CDM,3028676200,Analysis for antibody to Rubella (German measles virus),128.0,64.0,11.72,174.08,32
CDM,3028676500,Analysis for antibody to Rubeola (measles virus),100.0,50.0,11.72,136.0,32
CDM,3028676900,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,153.0,76.5,11.72,208.08,32
CDM,3028677700,Analysis for antibody to Toxoplasma (parasite),56.0,28.0,8.06,76.16,32
CDM,3028677800,Analysis for antibody (IgM) to Toxoplasma (parasite),57.0,28.5,8.21,77.52,32
CDM,3028678000,"Analysis for antibody, Treponema pallidum",120.0,60.0,11.72,163.2,32
CDM,3028678700,Analysis for antibody to varicella-zoster virus (chicken pox),123.0,61.5,11.72,167.28,32
CDM,3028678800,Analysis for antibody (IgM) to West Nile virus,59.0,29.5,9.94,80.24,32
CDM,3028678900,Analysis for antibody to West Nile virus,75.0,37.5,10.79,102.0,32
CDM,3028679001,Analysis for antibody to virus,116.0,58.0,11.72,157.76,32
CDM,3028679005,Analysis for antibody to virus,116.0,58.0,11.72,157.76,32
CDM,3028679009,Analysis for antibody to virus,116.0,58.0,11.72,157.76,32
CDM,3028679010,Analysis for antibody to virus,116.0,58.0,11.72,157.76,32
CDM,3028679018,Analysis for antibody to virus,116.0,58.0,11.72,157.76,32
CDM,3028680000,Thyroglobulin (thyroid protein) antibody measurement,130.0,65.0,11.72,176.8,32
CDM,3028680300,Hepatitis C antibody measurement,186.0,93.0,11.72,252.96,32
CDM,3028681200,"Immunologic analysis for autoimmune disease, A, B, or C, single antigen",177.0,88.5,4.51,240.72,32
CDM,3028682800,Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) antigens,1072.0,536.0,63.54,1457.92,32
CDM,3028683000,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",505.0,252.5,63.54,686.8,32
CDM,3028683100,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",505.0,252.5,63.54,686.8,32
CDM,3028683200,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",1166.0,583.0,164.94,3774.93,32
CDM,3028683300,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",1173.0,586.5,164.94,3821.63,32
CDM,3028685000,Screening test for red blood cell antibodies,138.0,69.0,4.51,187.68,32
CDM,3028685001,Screening test for red blood cell antibodies,244.0,122.0,4.51,331.84,32
CDM,3028686000,Removal of antibodies from surface of red blood cell,184.0,92.0,24.47,566.1,32
CDM,3028686001,Removal of antibodies from surface of red blood cell,329.0,164.5,24.47,566.1,32
CDM,3028687000,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687001,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687002,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687007,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687009,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687011,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687012,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687013,Identification of red blood cell antibodies,356.0,178.0,37.72,1166.8,32
CDM,3028687014,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028687016,Identification of red blood cell antibodies,1167.0,583.5,37.72,1587.12,32
CDM,3028688000,"Red blood cell antibody detection test, direct",95.0,47.5,4.51,129.2,32
CDM,3028688001,"Red blood cell antibody detection test, direct",95.0,47.5,4.51,129.2,32
CDM,3028688002,"Red blood cell antibody detection test, direct",95.0,47.5,4.51,129.2,32
CDM,3028688003,"Red blood cell antibody detection test, direct",95.0,47.5,4.51,129.2,32
CDM,3028688600,Red blood cell antibody level,169.0,84.5,4.51,229.84,32
CDM,3028688601,Red blood cell antibody level,169.0,84.5,4.51,229.84,32
CDM,3028690000,Blood group typing (ABO),180.0,90.0,4.51,244.8,32
CDM,3028690001,Blood group typing (ABO),202.0,101.0,4.51,274.72,32
CDM,3028690100,Blood typing for Rh (D) antigen,61.0,30.5,1.82,82.96,32
CDM,3028690101,Blood typing for Rh (D) antigen,74.0,37.0,2.21,100.64,32
CDM,3028690200,"Screening test for compatible blood unit, using reagent serum",562.0,281.0,4.51,764.32,32
CDM,3028690202,"Screening test for compatible blood unit, using reagent serum",562.0,281.0,4.51,764.32,32
CDM,3028690500,Blood typing for red blood cell antigens,562.0,281.0,4.08,764.32,32
CDM,3028690501,Blood typing for red blood cell antigens,160.0,80.0,4.08,217.6,32
CDM,3028690600,Blood typing Rh phenotyping,256.0,128.0,4.51,348.16,32
CDM,3028690601,Blood typing Rh phenotyping,256.0,128.0,4.51,348.16,32
CDM,3028692200,"Blood unit compatibility test, antiglobulin technique",567.0,283.5,25.22,771.12,32
CDM,3028692201,"Blood unit compatibility test, antiglobulin technique",368.0,184.0,25.22,566.1,32
CDM,3028692300,"Blood unit compatibility test, electronic",567.0,283.5,24.47,771.12,32
CDM,3028694000,Red blood cell antibody screening test,191.0,95.5,4.51,259.76,32
CDM,3028694500,"Irradiation of blood product, each unit",115.0,57.5,29.56,156.4,32
CDM,3028697000,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",93.0,46.5,20.39,126.48,32
CDM,3028697001,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",206.0,103.0,20.39,280.16,32
CDM,3028697100,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",268.0,134.0,40.93,1166.8,32
CDM,3028697101,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",522.0,261.0,40.93,1166.8,32
CDM,3028697200,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",268.0,134.0,32.63,566.1,32
CDM,3028697201,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",490.0,245.0,32.63,666.4,32
CDM,3028697800,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",127.0,63.5,27.53,172.72,32
CDM,3028697801,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",426.0,213.0,27.53,579.36,32
CDM,3028698500,Splitting of blood or blood products,268.0,134.0,20.39,566.1,32
CDM,3028732800,Detection test by immunoassay technique for Cryptosporidium (parasite),104.0,52.0,10.73,141.44,32
CDM,3028732900,Detection test by immunoassay technique for Giardia (intestinal parasite),147.0,73.5,10.73,199.92,32
CDM,3028738900,Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies,179.0,89.5,10.73,243.44,32
CDM,3058500700,Microscopic examination for white blood cells with manual cell count,60.0,30.0,2.28,81.6,32
CDM,3058501300,Red blood cell hemoglobin concentration,56.0,28.0,3.92,76.16,32
CDM,3058501400,Red blood cell concentration measurement,43.0,21.5,1.02,58.48,32
CDM,3058501800,"Blood count, hemoglobin",38.0,19.0,0.9,51.68,32
CDM,3058502500,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",93.0,46.5,6.04,126.48,32
CDM,3058502700,"Complete blood cell count (red cells, white blood cell, platelets), automated test",105.0,52.5,6.04,142.8,32
CDM,3058504500,"Red blood count, automated test",68.0,34.0,2.71,92.48,32
CDM,3058504800,Automated white blood cell count,48.0,24.0,1.22,65.28,32
CDM,3058504900,"Platelet count, automated test",61.0,30.5,2.73,82.96,32
CDM,3058505500,Reticulated (young) platelet measurement,44.0,22.0,15.73,128.66,32
CDM,3058506000,Blood smear interpretation by physician with written report,88.0,44.0,17.35,45.71,32
CDM,3058509700,"Bone marrow, smear interpretation",1277.0,638.5,57.84,2795.44,32
CDM,3058513000,Assessment of blood clotting function,193.0,96.5,6.04,262.48,32
CDM,3058521000,"Clotting factor II prothrombin, measurement",187.0,93.5,4.51,254.32,32
CDM,3058522000,Clotting factor V (AcG or proaccelerin) measurement,226.0,113.0,4.51,307.36,32
CDM,3058523000,"Clotting factor VII (proconvertin, stable factor)",219.0,109.5,4.51,297.84,32
CDM,3058524000,Clotting factor VIII (AHG) measurement,208.0,104.0,4.51,282.88,32
CDM,3058524500,Clotting factor VIII (VW factor) measurement,393.0,196.5,17.32,534.48,32
CDM,3058524600,Clotting factor VIII (VW factor) antigen,266.0,133.0,17.32,361.76,32
CDM,3058524700,Clotting factor VIII (von Willebrand factor) measurement,625.0,312.5,25.78,850.0,32
CDM,3058525000,Clotting factor IX (PTC or Christmas) measurement,289.0,144.5,22.42,393.04,32
CDM,3058526000,Clotting factor X (Stuart-Prower) measurement,175.0,87.5,4.51,238.0,32
CDM,3058527000,Clotting factor XI (PTA) measurement,182.0,91.0,4.51,247.52,32
CDM,3058528000,Clotting factor XII (Hageman) measurement,78.0,39.0,15.09,106.08,32
CDM,3058529100,Clotting factor XIII (fibrin stabilizing) screening test,34.0,17.0,3.1,46.24,32
CDM,3058530000,Antithrombin III antigen (clotting inhibitor) activity,171.0,85.5,4.51,232.56,32
CDM,3058530100,Antithrombin III antigen (clotting inhibitor) level,40.0,20.0,4.32,54.4,32
CDM,3058530200,"Protein C, (clotting inhibitor) activity",44.0,22.0,4.51,59.84,32
CDM,3058530300,Protein C antigen (clotting inhibitor) measurement,200.0,100.0,4.51,272.0,32
CDM,3058530500,Protein S (clotting inhibitor) level,136.0,68.0,4.51,184.96,32
CDM,3058530700,Activated protein resistance assay,116.0,58.0,6.04,157.76,32
CDM,3058533500,Clotting factor inhibitor test,260.0,130.0,4.51,353.6,32
CDM,3058534700,"Coagulation time measurement, activated",40.0,20.0,1.71,54.4,32
CDM,3058537900,"Coagulation function measurement, D-dimer; quantitative",120.0,60.0,4.51,163.2,32
CDM,3058538400,Fibrinogen (factor 1) activity measurement,60.0,30.0,4.51,81.6,32
CDM,3058539700,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,216.0,108.0,25.78,293.76,32
CDM,3058541000,Alpha-2 antiplasmin (factor inhibitor) measurement,28.0,14.0,2.16,38.08,32
CDM,3058541500,Plasminogen activator (fibrinolytic factor) measurement,70.0,35.0,4.51,95.2,32
CDM,3058542000,Plasminogen (fibrinolytic factor) measurement,282.0,141.0,4.51,383.52,32
CDM,3058546000,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",578.0,289.0,6.04,786.08,32
CDM,3058546100,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette",64.0,32.0,5.99,87.04,32
CDM,3058552000,Heparin assay,48.0,24.0,4.51,65.28,32
CDM,3058554900,White blood cell enzyme activity measurement,137.0,68.5,6.04,186.32,32
CDM,3058557600,Platelet aggregation function test,236.0,118.0,25.49,320.96,32
CDM,3058557601,Platelet aggregation function test,236.0,118.0,25.49,320.96,32
CDM,3058559700,Platelet function test,160.0,80.0,4.51,217.6,32
CDM,3058559800,Phospholipid test,212.0,106.0,4.51,288.32,32
CDM,3058561000,"Blood test, clotting time",50.0,25.0,2.15,68.0,32
CDM,3058561300,"Clotting factor X assessment test, diluted",32.0,16.0,3.07,43.52,32
CDM,3058563500,Blood coagulation screening test,35.0,17.5,3.45,47.6,32
CDM,3058565200,"Red blood cell sedimentation rate, to detect inflammation, automated",74.0,37.0,2.0,100.64,32
CDM,3058566000,Red blood cell sickling measurement,83.0,41.5,4.57,112.88,32
CDM,3058566001,Red blood cell sickling measurement,83.0,41.5,4.57,112.88,32
CDM,3058567000,"Thrombin time, fibrinogen screening test, plasma",50.0,25.0,2.89,68.0,32
CDM,3058570500,Thromboplastin inhibition (circulating anticoagulant) measurement,130.0,65.0,4.51,176.8,32
CDM,3058573000,"Coagulation assessment blood test, plasma or whole blood",130.0,65.0,4.51,176.8,32
CDM,3058573200,"Coagulation assessment blood test, substitution, plasma fractions",105.0,52.5,4.51,142.8,32
CDM,3058581000,Blood viscosity measurement,43.0,21.5,5.02,58.48,32
CDM,3061035,Chemistry procedures,662.12,331.06,0.5,900.49,32
CDM,3061052,Cholesterol level,71.0,35.5,3.09,96.56,32
CDM,3061062,Blood creatinine level,70.0,35.0,3.58,95.2,32
CDM,3061083,Hemoglobin A1C level,105.0,52.5,5.5,142.8,32
CDM,3061416,"Testing for presence of drug, read by direct observation",356.0,178.0,14.24,484.16,32
CDM,3068684900,Immunology procedures,377.0,188.5,0.5,512.72,32
CDM,3068701500,Concentration of specimen for infectious agents,64.0,32.0,4.28,87.04,32
CDM,3068704000,Bacterial blood culture,254.0,127.0,10.73,345.44,32
CDM,3068704500,Stool culture,128.0,64.0,10.73,174.08,32
CDM,3068704600,"Stool culture, additional pathogens",71.0,35.5,6.7,96.56,32
CDM,3068707000,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707001,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707002,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707003,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707007,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707009,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,32
CDM,3068707100,Bacterial culture and colony count,194.0,97.0,10.73,263.84,32
CDM,3068707101,Bacterial culture and colony count,194.0,97.0,10.73,263.84,32
CDM,3068707500,"Bacterial culture, any source, except blood, anaerobic",211.0,105.5,10.73,286.96,32
CDM,3068707600,Bacterial culture for anaerobic isolates,86.0,43.0,5.1,116.96,32
CDM,3068707700,Bacterial culture for aerobic isolates,49.0,24.5,3.96,66.64,32
CDM,3068708101,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708102,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708103,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708104,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708106,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708108,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708110,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,32
CDM,3068708600,"Bacterial colony count, urine",123.0,61.5,9.93,167.28,32
CDM,3068708800,Bacterial urine culture,91.0,45.5,7.36,123.76,32
CDM,3068710100,"Fungal culture (mold or yeast) of skin, hair, or nail",135.0,67.5,9.18,183.6,32
CDM,3068710200,Fungal culture (mold or yeast),115.0,57.5,9.67,156.4,32
CDM,3068710300,Fungal blood culture (mold or yeast),145.0,72.5,10.73,197.2,32
CDM,3068710600,"Fungal culture, yeast",112.0,56.0,10.73,152.32,32
CDM,3068710700,Culture for identification of yeast,120.0,60.0,10.73,163.2,32
CDM,3068710900,Mycoplasma culture,56.0,28.0,8.62,76.16,32
CDM,3068711600,Culture for acid-fast bacilli,150.0,75.0,10.73,204.0,32
CDM,3068711800,Identification of mycobacteria (TB or TB like organism),123.0,61.5,10.73,167.28,32
CDM,3068714700,"Identification of organisms by immunologic analysis, other than immunofluorescence method",47.0,23.5,2.43,63.92,32
CDM,3068715002,"Identification of organisms by genetic analysis, amplified probe technique",117.0,58.5,37.44,159.12,32
CDM,3068715003,"Identification of organisms by genetic analysis, amplified probe technique",117.0,58.5,37.44,159.12,32
CDM,3068716800,Macroscopic examination (visual inspection) of insect,65.0,32.5,2.78,88.4,32
CDM,3068716900,Macroscopic examination (visual inspection) of parasite,37.0,18.5,1.59,50.32,32
CDM,3068717200,Pinworm test,78.0,39.0,3.33,106.08,32
CDM,3068717600,Tissue preparation for culture,57.0,28.5,3.35,77.52,32
CDM,3068717700,Smear for parasites,54.0,27.0,4.81,73.44,32
CDM,3068718100,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",132.0,66.0,6.12,179.52,32
CDM,3068718400,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",78.0,39.0,5.83,106.08,32
CDM,3068718600,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",118.0,59.0,10.21,160.48,32
CDM,3068718800,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",138.0,69.0,8.16,187.68,32
CDM,3068720500,Special Gram or Giemsa stain for microorganism,72.0,36.0,3.07,97.92,32
CDM,3068720600,Special fluorescent and/or acid fast stain for microorganism,40.0,20.0,2.16,54.4,32
CDM,3068720702,Special stain for inclusion bodies or parasites,133.0,66.5,7.97,180.88,32
CDM,3068720900,Special stain for parasites,79.0,39.5,10.73,107.44,32
CDM,3068721000,Smear for infectious agents,60.0,30.0,3.49,81.6,32
CDM,3068725402,"Virus isolation, centrifuge enhanced",193.0,96.5,10.73,262.48,32
CDM,3068730100,Detection test by immunoassay technique for adenovirus enteric types 40/41,44.0,22.0,5.27,59.84,32
CDM,3068730500,Detection test by immunoassay technique for Aspergillus (fungus),133.0,66.5,10.73,180.88,32
CDM,3068732400,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),118.0,59.0,10.73,160.48,32
CDM,3068732700,"Detection test by immunoassay technique, multistep method, for Cryptococcus neoformans (yeast)",109.0,54.5,10.73,148.24,32
CDM,3068733800,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,145.0,72.5,10.73,197.2,32
CDM,3068734000,Detection test by immunoassay technique for hepatitis B surface antigen,135.0,67.5,10.73,183.6,32
CDM,3068735000,Detection test by immunoassay technique for hepatitis Be surface antigen,47.0,23.5,5.42,63.92,32
CDM,3068738500,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),230.0,115.0,10.73,312.8,32
CDM,3068742500,Detection test by immunoassay technique for rotavirus,44.0,22.0,5.27,59.84,32
CDM,3068743000,"Detection test by immunoassay technique for Streptococcus, group A (strep)",101.0,50.5,10.73,137.36,32
CDM,3068744901,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744902,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744903,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744904,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744905,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744906,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744907,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068744910,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,32
CDM,3068748600,"Detection test by nucleic acid for Chlamydia pneumoniae, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068749100,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",165.0,82.5,41.79,224.4,32
CDM,3068749300,"Detection test by nucleic acid for clostridium difficile, amplified probe technique",151.0,75.5,43.62,205.36,32
CDM,3068749600,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",302.0,151.0,41.79,410.72,32
CDM,3068749700,"Detection test by nucleic acid for cytomegalovirus, quantification",333.0,166.5,43.62,452.88,32
CDM,3068749800,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",145.0,72.5,41.79,197.2,32
CDM,3068750200,Detection test by nucleic acid for multiple types influenza virus,259.0,129.5,82.88,352.24,32
CDM,3068751700,"Detection test by nucleic acid for Hepatitis B virus, quantification",326.0,163.0,43.62,443.36,32
CDM,3068752100,"Detection test by nucleic acid for Hepatitis C virus, amplified probe technique",163.0,81.5,41.79,221.68,32
CDM,3068752200,"Detection test by nucleic acid for Hepatitis C virus, quantification",385.0,192.5,43.62,523.6,32
CDM,3068752900,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",303.0,151.5,41.79,412.08,32
CDM,3068752901,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",303.0,151.5,41.79,412.08,32
CDM,3068752902,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",303.0,151.5,41.79,412.08,32
CDM,3068753000,"Detection test by nucleic acid for herpes simplex virus, quantification",322.0,161.0,43.62,437.92,32
CDM,3068753300,"Detection test by nucleic acid for herpes virus-6, quantification",145.0,72.5,43.62,197.2,32
CDM,3068753500,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",337.0,168.5,41.79,458.32,32
CDM,3068753600,"Detection test by nucleic acid for HIV-1 virus, quantification",524.0,262.0,43.62,712.64,32
CDM,3068755600,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",396.0,198.0,41.79,538.56,32
CDM,3068758100,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068759100,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",157.0,78.5,41.79,213.52,32
CDM,3068762402,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",188.0,94.0,43.62,255.68,32
CDM,3068762403,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",188.0,94.0,43.62,255.68,32
CDM,3068763500,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,272.0,136.0,43.62,369.92,32
CDM,3068765100,"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique",127.0,63.5,41.79,172.72,32
CDM,3068766100,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",162.0,81.0,23.44,220.32,32
CDM,3068766200,"Detection test by nucleic acid for Zika virus, amplified probe technique",177.0,88.5,43.62,240.72,32
CDM,3068779800,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779802,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779803,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779804,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779805,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779806,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779817,"Detection test by nucleic acid for organism, amplified probe technique",111.0,55.5,38.95,150.96,32
CDM,3068779818,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779822,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779823,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779829,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779832,"Detection test by nucleic acid for organism, amplified probe technique",130.0,65.0,41.79,176.8,32
CDM,3068779900,"Detection test by nucleic acid for organism, quantification",750.0,375.0,43.62,1020.0,32
CDM,3068779901,"Detection test by nucleic acid for organism, quantification",548.0,274.0,43.62,745.28,32
CDM,3068779902,"Detection test by nucleic acid for organism, quantification",600.0,300.0,43.62,816.0,32
CDM,3068779903,"Detection test by nucleic acid for organism, quantification",600.0,300.0,43.62,816.0,32
CDM,3068780100,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",277.0,138.5,43.62,376.72,32
CDM,3068780101,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",277.0,138.5,43.62,376.72,32
CDM,3068780102,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",277.0,138.5,43.62,376.72,32
CDM,3068780106,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",277.0,138.5,43.62,376.72,32
CDM,3068780800,Detection test by immunoassay with direct visual observation for Trichomonas vaginal (genital parasite),92.0,46.0,10.73,125.12,32
CDM,3068789902,Detection test by immunoassay with direct visual observation for other organism,115.0,57.5,10.73,156.4,32
CDM,3068790100,Analysis test by nucleic acid for HIV-1 virus,895.0,447.5,167.65,2304.18,32
CDM,3068790200,Analysis test by nucleic acid for Hepatitis C virus,813.0,406.5,167.65,2093.07,32
CDM,3078100100,"Manual urinalysis test with examination using microscope, automated",68.0,34.0,2.16,92.48,32
CDM,3078100200,"Urinalysis, manual test",43.0,21.5,1.5,58.48,32
CDM,3078100300,Automated urinalysis test,42.0,21.0,0.95,57.12,32
CDM,3078101500,Urinalysis using microscope,43.0,21.5,1.31,58.48,32
CDM,3078102500,Urine pregnancy test,87.0,43.5,3.06,118.32,32
CDM,3098427500,Sialic acid (organic acid) level,46.0,23.0,6.18,62.56,32
CDM,3098905100,Body fluid cell count with cell identification,111.0,55.5,5.05,150.96,32
CDM,3098905500,"White blood cell measure, stool specimen",82.0,41.0,3.5,111.52,32
CDM,3098906000,Crystal identification from tissue or body fluid,97.0,48.5,5.05,131.92,32
CDM,3098932100,Semen analysis for sperm presence,255.0,127.5,5.05,346.8,32
CDM,3100041600,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS, FOR PROSTATE NEEDLE BIOPSY, ANY METHOD",2667.0,1333.5,165.12,3627.12,32
CDM,3103820700,Preservation and storage of stem cells for transplantation,4650.0,2325.0,568.05,6324.0,32
CDM,3103821500,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),3674.0,1837.0,568.05,4996.64,32
CDM,3108122500,"Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants",863.0,431.5,167.65,2514.44,32
CDM,3108126300,"Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis",806.0,403.0,167.65,2373.83,32
CDM,3108130500,Gene analysis (myeloid differentiation primary response 88) for p.Leu265Pro variant,895.0,447.5,167.65,1569.83,32
CDM,3108134200,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),651.0,325.5,167.65,1311.77,32
CDM,3108135200,Gene analysis (tumor protein 53) targeted sequence analysis,2025.0,1012.5,167.65,6672.58,32
CDM,3108140400,Molecular pathology procedure level 5 genetic analysis,1476.0,738.0,167.65,4056.49,32
CDM,3108764100,"Detection test by nucleic acid for Staphylococcus aureus, methicillin resistant (MRSA bacteria), amplified probe technique",204.0,102.0,41.79,277.44,32
CDM,3108817500,"Pap test, automated thin layer preparation; automated system and manual rescreening",161.0,80.5,20.82,218.96,32
CDM,3108827100,DNA testing for genetic defects,179.0,89.5,17.32,243.44,32
CDM,3108827103,DNA testing for genetic defects,179.0,89.5,17.32,243.44,32
CDM,3108827104,DNA testing for genetic defects,179.0,89.5,17.32,243.44,32
CDM,3108827106,DNA testing for genetic defects,179.0,89.5,17.32,243.44,32
CDM,3108827107,DNA testing for genetic defects,179.0,89.5,17.32,243.44,32
CDM,3108830200,Pathology examination of tissue using a microscope,278.0,139.0,31.6,378.08,32
CDM,3108830400,"Pathology examination of tissue using a microscope, moderately low complexity",530.0,265.0,40.47,720.8,32
CDM,3108830500,"Pathology examination of tissue using a microscope, intermediate complexity",542.0,271.0,40.47,737.12,32
CDM,3108830700,"Pathology examination of tissue using a microscope, moderately high complexity",1167.0,583.5,165.12,1587.12,32
CDM,3108830900,"Pathology examination of tissue using a microscope, high complexity",1654.0,827.0,165.12,2795.44,32
CDM,3108832100,Surgical pathology consultation and report on referred slides prepared elsewhere,274.0,137.0,48.09,372.64,32
CDM,3108833100,"Pathology examination of specimen during surgery, first tissue block",567.0,283.5,40.78,771.12,32
CDM,3108833200,"Pathology examination of specimen during surgery, each additional tissue block",191.0,95.5,14.27,259.76,32
CDM,3108834200,"Special stained specimen slides to examine tissue, initial procedure",567.0,283.5,90.83,771.12,32
CDM,3108834201,"Special stained specimen slides to examine tissue, initial procedure",567.0,283.5,90.83,771.12,32
CDM,3108834203,"Special stained specimen slides to examine tissue, initial procedure",567.0,283.5,90.83,771.12,32
CDM,3108834400,"Special stained specimen slides to examine tissue, each multiplex procedure",1167.0,583.5,90.83,1587.12,32
CDM,3108834601,"Antibody evaluation, initial single antibody stain procedure",1167.0,583.5,78.49,1587.12,32
CDM,3108834602,"Antibody evaluation, initial single antibody stain procedure",1167.0,583.5,78.49,1587.12,32
CDM,3108834800,Electron microscopy for diagnosis,2553.0,1276.5,165.12,3472.08,32
CDM,3108836500,"Genetic sequencing localization, initial procedure",567.0,283.5,133.54,771.12,32
CDM,3108836504,"Genetic sequencing localization, initial procedure",567.0,283.5,133.54,771.12,32
CDM,3118810400,"Cell examination of body fluid, smears",231.0,115.5,33.44,314.16,32
CDM,3118810800,"Cell examination of specimen, concentration technique",250.0,125.0,33.44,340.0,32
CDM,3118811200,"Cell examination of specimen, selective cellular enhancement technique",283.0,141.5,33.44,384.88,32
CDM,3118814200,"Pap test, manual screening",149.0,74.5,5.66,202.64,32
CDM,3118816000,"Screening examination of specimen cells, screening and interpretation",199.0,99.5,33.44,270.64,32
CDM,3118817200,Evaluation of fine needle aspirate,567.0,283.5,37.0,771.12,32
CDM,3118817300,Evaluation of fine needle aspirate with interpretation and report,630.0,315.0,67.1,856.8,32
CDM,3118817700,"Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode",153.0,76.5,13.65,208.08,32
CDM,3118818200,Flow cytometry technique for DNA or cell analysis,549.0,274.5,33.44,746.64,32
CDM,3118818400,"Flow cytometry technique for DNA or cell analysis, first marker",1167.0,583.5,108.05,1587.12,32
CDM,3118818500,"Flow cytometry technique for DNA or cell analysis, each additional marker",150.0,75.0,33.44,204.0,32
CDM,3118818700,"Flow cytometry technique for DNA or cell analysis, 2 to 8 markers",594.0,297.0,33.44,807.84,32
CDM,3118823000,Tissue culture to identify white blood cell disorders,676.0,338.0,185.49,919.36,32
CDM,3118823700,Tissue culture for tumor disorders of bone marrow and blood cells,1011.0,505.5,185.49,1453.31,32
CDM,3118824000,"Cryopreservation, freezing and storage of cells",486.0,243.0,5.05,660.96,32
CDM,3118826200,"Chromosome analysis for genetic defects, count 15-20 cells",1017.0,508.5,47.41,1383.12,32
CDM,3118827300,"Chromosome analysis for genetic defects, analyze 10-30 cells",775.0,387.5,38.73,1054.0,32
CDM,3118827400,"Chromosome analysis for genetic defects, analyze 25-99 cells",538.0,269.0,41.79,731.68,32
CDM,3118827500,"Chromosome analysis for genetic defects, analyze 100-300 cells",554.0,277.0,47.41,753.44,32
CDM,3118833300,"Pathology cytologic examination of specimen during surgery, initial site",1654.0,827.0,43.83,2795.44,32
CDM,3118833400,"Pathology cytologic examination of specimen during surgery, each additional site",158.0,79.0,26.5,214.88,32
CDM,3128831100,Preparation of tissue for examination by removing any calcium present,93.0,46.5,8.16,126.48,32
CDM,3128831200,Special stained specimen slides to identify organisms including interpretation and report,186.0,93.0,40.47,252.96,32
CDM,3128831300,Special stained specimen slides to examine tissue including interpretation and report,270.0,135.0,24.47,367.2,32
CDM,3128832300,Surgical pathology consultation and report on referred material requiring preparation of slides,268.0,134.0,67.1,364.48,32
CDM,3128834100,"Special stained specimen slides to examine tissue, each additional procedure",273.0,136.5,40.47,371.28,32
CDM,3128835000,"Antibody evaluation, each additional single antibody stain procedure",403.0,201.5,40.47,548.08,32
CDM,3128836000,"Microscopic genetic analysis of tumor, manual",567.0,283.5,89.71,771.12,32
CDM,3128836002,"Microscopic genetic analysis of tumor, manual",567.0,283.5,89.71,771.12,32
CDM,3128836100,"Microscopic genetic analysis of tumor, using computer-assisted technology",596.0,298.0,129.46,1166.8,32
CDM,3128837701,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",958.0,479.0,165.12,1302.88,32
CDM,3128837702,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",958.0,479.0,165.12,1302.88,32
CDM,3128838700,"Pathologist examination, dissection, and preparation of tissue",88.0,44.0,17.5,119.68,32
CDM,3148830000,"Pathology examination of tissue using a microscope, limited examination",121.0,60.5,20.11,164.56,32
CDM,3191037,"Semen evaluation volume, sperm count, motility and analysis",251.0,125.5,5.05,341.36,32
CDM,3191044,Automated urinalysis test,42.0,21.0,0.95,57.12,32
CDM,3191047,"Urinalysis, manual test",43.0,21.5,1.5,58.48,32
CDM,3191077,"Blood test, clotting time",50.0,25.0,2.15,68.0,32
CDM,3193820800,Thawing of frozen stem cells for transplantation,1287.0,643.5,386.1,2175.73,32
CDM,3198836400,"Genetic sequencing localization, each additional procedure",395.0,197.5,40.47,537.2,32
CDM,3319640100,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,713.0,356.5,58.14,969.68,32
CDM,3319640200,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,580.0,290.0,58.14,788.8,32
CDM,3319640900,Administration of chemotherapy into vein using push technique,933.0,466.5,58.14,1268.88,32
CDM,3319641100,Administration of additional new drug or substance into vein using push technique,651.0,325.5,58.14,885.36,32
CDM,3319645000,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,1898.0,949.0,425.3,2581.28,32
CDM,3335715500,Insertion of device into uterus for radiation therapy,9715.0,4857.5,2914.5,13212.4,32
CDM,3335715600,Insertion of device into vagina for radiation therapy,1581.0,790.5,392.37,2150.16,32
CDM,3337728000,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",2466.0,1233.0,150.79,3353.76,32
CDM,3337728500,"Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas",3319.0,1659.5,234.07,4513.84,32
CDM,3337729000,"Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved",4520.0,2260.0,234.07,6147.2,32
CDM,3337729300,Obtaining respiratory data needed to develop the optimal radiation treatment,3172.0,1586.0,150.79,4313.92,28
CDM,3337729500,3D radiation therapy planning,10195.0,5097.5,496.18,13865.2,32
CDM,3337730000,Calculation of radiation therapy dose,1080.0,540.0,63.63,1468.8,32
CDM,3337730100,High precision radiation therapy planning,15180.0,7590.0,1335.85,20644.8,32
CDM,3337730600,Simple radiation therapy planning for delivery of external radiation,4116.0,2058.0,142.21,5597.76,32
CDM,3337730700,Complex radiation therapy planning for delivery of external radiation,5189.0,2594.5,167.08,7057.04,32
CDM,3337731600,Simple radiation therapy planning for delivery of internal radiation,1494.0,747.0,146.89,2031.84,32
CDM,3337731700,Intermediate radiation therapy planning for delivery of internal radiation,2035.0,1017.5,216.42,2767.6,32
CDM,3337732100,Special radiation therapy planning for delivery of external radiation,2248.0,1124.0,80.52,3057.28,32
CDM,3337733100,Special radiation therapy planning,1126.0,563.0,31.39,1531.36,32
CDM,3337733200,Design and construction of simple radiation treatment device,1111.0,555.5,84.1,1510.96,32
CDM,3337733300,Design and construction of intermediate radiation treatment device,1552.0,776.0,18.17,2110.72,32
CDM,3337733400,Design and construction of complex radiation treatment device,2694.0,1347.0,163.03,3663.84,32
CDM,3337733600,Continuing radiation therapy consultation per week,1175.0,587.5,88.11,1598.0,32
CDM,3337733800,Design and construction of radiation treatment device for high precision radiation therapy,3566.0,1783.0,234.07,4849.76,32
CDM,3337737000,Special medical radiation therapy consultation,1224.0,612.0,114.37,1664.64,32
CDM,3337737200,Complete single session course of cranial lesion surgery using radiation and a machine to deliver external radiation,30831.0,15415.5,1109.1,41930.16,32
CDM,3337737300,Delivery of radiation therapy per dose to 1 or more lesions not to exceed 5 doses,16011.0,8005.5,1785.79,21774.96,32
CDM,3337738700,Imaging guidance for localization of radiation treatment,1930.0,965.0,71.44,2624.8,32
CDM,3337740200,Delivery of simple radiation treatment,989.0,494.5,66.43,1345.04,32
CDM,3337741700,X-ray during radiation therapy,599.0,299.5,25.53,814.64,32
CDM,3337747000,Special radiation treatment,4044.0,2022.0,89.58,5499.84,32
CDM,3337775000,Infusion or instillation of radioelement solution,826.0,413.0,82.98,1123.36,32
CDM,3337776300,Complex body cavity radiation source application,4034.0,2017.0,279.21,5486.24,32
CDM,3337777000,"High dose radiation therapy, 1 channel",3237.0,1618.5,405.91,4402.32,64
CDM,3337777100,"High dose radiation therapy, 2-12 channels",5683.0,2841.5,739.1,7728.88,64
CDM,3337777200,"High dose radiation therapy, more than 12 channels",9009.0,4504.5,837.0,12252.24,32
CDM,3337777800,Complex application of radiation source,5668.0,2834.0,320.7,7708.48,32
CDM,3359641300,"Administration of chemotherapy into vein, 1 hour or less",1875.0,937.5,42.23,2550.0,32
CDM,3359641500,"Administration of chemotherapy into vein, each additional hour",843.0,421.5,92.71,1146.48,32
CDM,3359641600,Administration of prolonged chemotherapy into vein,1969.0,984.5,425.3,2677.84,32
CDM,3359641700,"Administration of additional new drug or substance into vein, 1 hour or less",952.0,476.0,92.71,1294.72,32
CDM,3430998300,"FLORBETABEN F18, DIAGNOSTIC, PER STUDY DOSE, UP TO 8.1 MILLICURIES",9535.0,4767.5,2614.71,12967.6,27
CDM,3481084,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,272.0,136.0,43.62,369.92,64
CDM,3527558000,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",4382.0,2191.0,425.0,5959.52,28
CDM,3543025,Drawing of blood for a medical problem,461.0,230.5,94.28,626.96,32
CDM,3543033,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",552.0,276.0,121.68,750.72,32
CDM,3545010,"Screening test for compatible blood unit, using reagent serum",562.0,281.0,4.51,764.32,32
CDM,3545020,HB LAB UNIT SEARCH RARE,811.0,405.5,202.75,535.26,16
CDM,3600002,Creation of opening in skull for insertion of brain tube or monitoring device,2800.0,1400.0,840.0,7095.56,32
CDM,3600016,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,2104.0,1052.0,178.73,2861.44,32
CDM,3600022,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,1979.0,989.5,500.68,2691.44,32
CDM,3600201,Removal of blood flow assist device in aorta,2875.0,1437.5,862.5,9612.57,32
CDM,3610913000,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, with imaging supervision, interpretation, and report, performed on a single major coronary artery or branch",17105.0,8552.5,5131.5,23262.8,26
CDM,3610914000,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement ",9408.0,4704.0,2822.4,12794.88,26
CDM,3611006000,Simple or single drainage of skin abscess,1096.0,548.0,207.21,1490.56,32
CDM,3611006100,Complicated or multiple drainage of skin abscess,1403.0,701.5,207.21,1908.08,32
CDM,3611007,Mechanical separation of plasma from blood,6197.0,3098.5,1859.1,8427.92,32
CDM,3611008000,Simple drainage of cyst of tailbone,1332.0,666.0,207.21,1811.52,32
CDM,3611008100,Complicated drainage of cyst of tailbone,1950.0,975.0,585.0,2652.0,32
CDM,3611009,Transfusion of blood or blood products,1304.0,652.0,391.2,1773.44,32
CDM,3611012000,"Removal of foreign body from tissue, accessed beneath the skin, simple",1131.0,565.5,207.21,1538.16,32
CDM,3611012100,"Removal of foreign body from tissue, accessed beneath the skin, complex",3438.0,1719.0,1031.4,4675.68,32
CDM,3611014000,Drainage of blood or fluid accumulation,4113.0,2056.5,1233.9,5593.68,32
CDM,3611018000,Complex drainage of wound infection after surgery,4923.0,2461.5,1274.65,6695.28,32
CDM,3611140200,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",2613.0,1306.5,527.72,3553.68,32
CDM,3611171900,Trimming of fingernails or toenails,167.0,83.5,50.1,227.12,32
CDM,3611173000,"Simple separation of fingernail or toenail from nail bed, first nail",619.0,309.5,83.37,841.84,32
CDM,3611173200,"Simple separation of fingernail or toenail from nail bed, each additional nail",207.0,103.5,62.1,281.52,32
CDM,3611174000,Removal of blood accumulation under fingernail or toenail,454.0,227.0,83.37,617.44,32
CDM,3611175000,Permanent removal fingernail or toenail,1307.0,653.5,392.1,1777.52,32
CDM,3611176000,Repair of fingernail or toenail bed,1126.0,563.0,83.37,1531.36,32
CDM,3611176500,Removal of skin of fingernail or toenail,890.0,445.0,83.37,1210.4,32
CDM,3611198200,Removal of drug delivery implant from tissue,1032.0,516.0,207.21,1403.52,32
CDM,3611198300,Removal with reinsertion of drug delivery implant into tissue,1738.0,869.0,207.21,2363.68,32
CDM,3611200100,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",847.0,423.5,228.76,1151.92,32
CDM,3611200200,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",972.0,486.0,228.76,1321.92,32
CDM,3611200400,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",1135.0,567.5,228.76,1543.6,32
CDM,3611200500,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",1385.0,692.5,228.76,1883.6,32
CDM,3611200600,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",1558.0,779.0,228.76,2118.88,32
CDM,3611201100,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",891.0,445.5,228.76,1211.76,32
CDM,3611201300,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",948.0,474.0,228.76,1289.28,32
CDM,3611201400,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1168.0,584.0,228.76,1588.48,32
CDM,3611201500,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1235.0,617.5,228.76,1679.6,32
CDM,3611201600,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1297.0,648.5,228.76,1763.92,32
CDM,3611202000,Simple closure of surface wound reopening,1404.0,702.0,421.2,1909.44,32
CDM,3611202100,Repair of separation of wound closure with insertion of packing,1210.0,605.0,363.0,1645.6,32
CDM,3611203100,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",1037.0,518.5,311.1,1410.32,32
CDM,3611203200,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",1367.0,683.5,410.1,1859.12,32
CDM,3611203400,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",1680.0,840.0,479.14,2284.8,32
CDM,3611203700,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",3541.0,1770.5,479.14,4815.76,32
CDM,3611204100,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",1008.0,504.0,302.4,1370.88,32
CDM,3611204200,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",1250.0,625.0,375.0,1700.0,32
CDM,3611204500,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",1644.0,822.0,479.14,2235.84,32
CDM,3611205100,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",1185.0,592.5,355.5,1611.6,32
CDM,3611205200,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",1293.0,646.5,387.9,1758.48,32
CDM,3611205300,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1384.0,692.0,415.2,1882.24,32
CDM,3611205400,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1437.0,718.5,431.1,1954.32,32
CDM,3611205600,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",2256.0,1128.0,479.14,3068.16,32
CDM,3611310100,"Complicated repair of wound of trunk, 2.6-7.5 cm",2039.0,1019.5,527.72,2773.04,32
CDM,3611312100,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",1745.0,872.5,523.42,2373.2,32
CDM,3611312200,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",741.0,370.5,222.3,1007.76,32
CDM,3611313100,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",1419.0,709.5,425.7,1929.84,32
CDM,3611313200,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",2099.0,1049.5,523.42,2854.64,32
CDM,3611313300,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",674.0,337.0,202.2,916.64,32
CDM,3611315100,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",2529.0,1264.5,527.72,3439.44,32
CDM,3611315200,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",2734.0,1367.0,527.72,3718.24,32
CDM,3611583900,Removal of extra skin and tissue of other area,9277.0,4638.5,2243.66,12616.72,32
CDM,3611799900,"Other procedure on skin, mucous membrane, and tissue",688.0,344.0,206.4,935.68,32
CDM,3611900000,"Aspiration of cyst of breast, first cyst",1523.0,761.5,456.9,2071.28,32
CDM,3611902000,Drainage of abscess of breast,3605.0,1802.5,1081.5,4902.8,32
CDM,3612060500,Aspiration and/or injection of fluid from medium joint,1110.0,555.0,308.97,1509.6,32
CDM,3612060600,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,1348.0,674.0,404.4,1833.28,32
CDM,3612061000,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,32
CDM,3612061100,Aspiration and/or injection of fluid large joint using ultrasound guidance,1650.0,825.0,395.23,2244.0,32
CDM,3612065000,Insertion of wire or pin to bone for traction,9598.0,4799.0,2879.4,13053.28,32
CDM,3612108600,Impression and custom preparation of outer ear prosthesis,9557.0,4778.5,2867.1,12997.52,32
CDM,3612290200,"Removal of growth of soft tissue of abdominal wall, less than 3.0 cm",5067.0,2533.5,1520.1,6891.12,32
CDM,3612290300,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",7082.0,3541.0,2124.6,9631.52,32
CDM,3612366500,Closed treatment of dislocated shoulder and broken upper arm bone at shoulder joint with manipulation,3656.0,1828.0,577.3,4972.16,32
CDM,3612407600,"Removal of growth of muscle of upper arm or elbow, less than 5.0 cm",9845.0,4922.5,2246.0,13389.2,32
CDM,3612420000,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",4514.0,2257.0,1354.2,6139.04,32
CDM,3612450000,Closed treatment of broken middle part of upper arm bone,844.0,422.0,253.2,1147.84,32
CDM,3612465000,Closed treatment of broken forearm bone on thumb side at elbow,730.0,365.0,219.0,992.8,32
CDM,3612526000,Primary repair of tendon or muscle of palm side of forearm or wrist,9598.0,4799.0,2132.43,13053.28,32
CDM,3612601000,Simple drainage of abscess of finger,837.0,418.5,207.21,1138.32,32
CDM,3612601100,Complicated drainage of abscess in finger,3013.0,1506.5,903.9,4097.68,32
CDM,3612670500,Closed treatment of dislocated hand joint at base of finger with manipulation under anesthesia,5005.0,2502.5,1211.37,6806.8,32
CDM,3612674000,Closed treatment of broken finger or hand at base of finger,699.0,349.5,209.7,950.64,32
CDM,3612708600,"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin",8426.0,4213.0,2246.0,11459.36,32
CDM,3612726600,Closed treatment of dislocated hip prosthesis under anesthesia,3933.0,1966.5,1179.9,5348.88,32
CDM,3612730100,Drainage of deep abscess or blood accumulation of thigh or knee,8428.0,4214.0,2246.0,11462.08,32
CDM,3612753000,Closed treatment of broken shin bone,1261.0,630.5,317.61,1714.96,32
CDM,3612759900,Other procedure on thigh or knee,741.0,370.5,222.3,1007.76,32
CDM,3612778600,Closed treatment of broken outside lower leg bone at ankle,866.0,433.0,259.8,1177.76,32
CDM,3612780800,Closed treatment of 2 broken lower leg bones at ankle,893.0,446.5,267.9,1214.48,32
CDM,3612783000,Closed treatment of dislocated knee joint,874.0,437.0,262.2,1188.64,32
CDM,3612789900,Other procedure on leg or ankle,750.0,375.0,225.0,1020.0,32
CDM,3612819000,"Removal of foreign body of foot tissue, accessed beneath the skin",2635.0,1317.5,527.72,3583.6,32
CDM,3612847000,Closed treatment of broken bone in forefoot or midfoot,856.0,428.0,256.8,1164.16,32
CDM,3612906500,Application of shoulder to hand cast,674.0,337.0,84.1,916.64,32
CDM,3612907500,Application of elbow to finger cast,939.0,469.5,70.65,1277.04,32
CDM,3612926000,Placement of strapping to elbow or wrist,372.0,186.0,75.96,505.92,32
CDM,3612928000,Placement of strapping to hand or finger,356.0,178.0,37.0,484.16,32
CDM,3612940500,Application of short leg cast,874.0,437.0,82.98,1188.64,32
CDM,3612953000,Placement of strapping to knee,441.0,220.5,47.09,599.76,32
CDM,3612955000,Placement of strapping to toes,374.0,187.0,38.12,508.64,32
CDM,3613000000,Drainage of abscess or blood accumulation of nose,799.0,399.5,212.62,1086.64,32
CDM,3613002000,Drainage of abscess or blood accumulation of nasal cartilage,2463.0,1231.5,694.44,3349.68,32
CDM,3613006,Mechanical separation of red blood cells from blood,4883.0,2441.5,1464.9,6640.88,32
CDM,3613010,Collection of donor stem cells for transplantation,4725.0,2362.5,1417.5,6426.0,30
CDM,3613013,Collection of stem cells for transplantation,7051.0,3525.5,2005.33,9589.36,30
CDM,3613017,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis",5428.0,2714.0,1628.4,19194.56,32
CDM,3613030000,Removal of foreign body in nose,347.0,173.5,104.1,471.92,32
CDM,3613046900,Repair of collapsed nasal valve,11727.0,5863.5,3180.04,15948.72,32
CDM,3613090100,Simple control of nose bleed,779.0,389.5,171.32,1059.44,32
CDM,3613090300,Complex control of nose bleed,857.0,428.5,171.32,1165.52,32
CDM,3613093000,Therapeutic fracture of nasal passages,9592.0,4796.0,2877.6,13045.12,32
CDM,3613124200,Destruction of nasal nerve by heat using an endoscope,16757.0,8378.5,5027.1,22789.52,28
CDM,3613124300,Destruction of nasal nerve by freezing using an endoscope,16757.0,8378.5,5027.1,22789.52,28
CDM,3613150000,Emergent insertion of breathing tube into windpipe using an endoscope,920.0,460.0,276.0,1251.2,32
CDM,3613150200,Change of breathing tube in windpipe,534.0,267.0,160.2,726.24,32
CDM,3613151100,Removal of foreign body in voice box using an endoscope with mirror,800.0,400.0,212.62,1088.0,32
CDM,3613157700,Removal of foreign body in voice box using a flexible endoscope,1514.0,757.0,454.2,2059.04,32
CDM,3613162200,Diagnostic exam of lung airway using an endoscope,3730.0,1865.0,1119.0,5072.8,32
CDM,3613162300,Exam of lung airways using an endoscope,3500.0,1750.0,1050.0,4760.0,32
CDM,3613162400,Irrigation and suction of lung airways to obtain cells using an endoscope,4180.0,2090.0,1254.0,5684.8,32
CDM,3613162500,Biopsy of lung airway using an endoscope,4380.0,2190.0,1314.0,5956.8,32
CDM,3613162700,Computer-assisted image-guided navigation of lung airways using an endoscope,2697.0,1348.5,809.1,3667.92,28
CDM,3613162800,"Biopsy of lobe of lung using an endoscope, 1 lobe",6143.0,3071.5,1842.9,8354.48,32
CDM,3613162900,"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope",6405.0,3202.5,1921.5,8710.8,32
CDM,3613163000,Dilation of windpipe cartilage or treatment of broken windpipe cartilage using an endoscope,6534.0,3267.0,1960.2,8886.24,32
CDM,3613163200,"Biopsy of lobe of lung using an endoscope, each additional lobe",2570.0,1285.0,771.0,3495.2,32
CDM,3613163300,"Needle biopsy of lobe of lung using an endoscope, each additional lobe",2570.0,1285.0,771.0,3495.2,32
CDM,3613163400,Exam of lung airways with repair of air leak using an endoscope,10824.0,5412.0,3247.2,14720.64,32
CDM,3613163600,"Placement of stent in lung airway using an endoscope, first stent",12266.0,6133.0,3679.8,16681.76,32
CDM,3613164000,Removal of growth of lung airways using an endoscope,6295.0,3147.5,1888.5,8561.2,32
CDM,3613164100,Destruction of growth or narrowing of lung airway using an endoscope,7097.0,3548.5,2129.1,9651.92,32
CDM,3613164700,Assessment of initial lobe of lung for air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope,11041.0,5520.5,3312.3,15015.76,32
CDM,3613164800,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, initial lobe",5881.0,2940.5,1764.3,7998.16,32
CDM,3613164900,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, each additional lobe",2906.0,1453.0,871.8,4857.83,32
CDM,3613165200,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes",8250.0,4125.0,2475.0,11220.0,32
CDM,3613165300,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes",8002.0,4001.0,2400.6,10882.72,32
CDM,3613165400,Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound,4685.0,2342.5,1405.5,6371.6,32
CDM,3613255000,Insertion of indwelling tube for drainage of lung fluid,7917.0,3958.5,1250.4,10767.12,32
CDM,3613255100,Removal of fluid from between lung and chest cavity,2672.0,1336.0,801.6,3633.92,32
CDM,3613255200,Removal of indwelling tube in lining of lung,1968.0,984.0,590.4,2676.48,32
CDM,3613255400,Aspiration of fluid from chest cavity,1686.0,843.0,505.8,2292.96,32
CDM,3613255500,Aspiration of fluid from chest cavity using imaging guidance,2219.0,1109.5,665.7,3017.84,32
CDM,3613255600,Drainage of fluid from chest cavity with insertion of indwelling tube,2966.0,1483.0,889.8,4033.76,32
CDM,3613255700,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,3300.0,1650.0,990.0,4488.0,32
CDM,3613646600,Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance,5407.0,2703.5,797.04,7353.52,32
CDM,3613646800,"Injection of chemical agent into spider vein of arm, leg, or trunk",1182.0,591.0,354.6,1607.52,32
CDM,3613648200,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,13443.0,6721.5,3413.75,18282.48,32
CDM,3613655500,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),4922.0,2461.0,1377.13,6693.92,32
CDM,3613655600,Insertion of non-tunneled central venous tube for infusion (5 years or older),4922.0,2461.0,1377.13,6693.92,32
CDM,3613655700,Insertion of tunneled central venous tube for infusion (younger than 5 years),8453.0,4226.5,2535.9,11496.08,32
CDM,3613657200,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",2468.0,1234.0,740.4,3356.48,32
CDM,3613657300,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",4302.0,2151.0,1290.6,5850.72,32
CDM,3613658100,Replacement of tunneled central venous tube,5619.0,2809.5,1685.7,7641.84,32
CDM,3613658400,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,3172.0,1586.0,951.6,4313.92,32
CDM,3613658900,Removal of tunneled central venous tube,2874.0,1437.0,807.71,3908.64,32
CDM,3613662000,Insertion of artery tube for blood sampling or infusion through skin,938.0,469.0,281.4,1275.68,32
CDM,3613668000,Insertion of needle for infusion into bone,861.0,430.5,258.3,1170.96,32
CDM,3613779900,Other procedure on blood vessel,17732.0,8866.0,807.71,24115.52,32
CDM,3613821400,Preparation of stem cells for transplantation with reduction of blood fluid (plasma) volume,1286.0,643.0,385.8,2175.73,32
CDM,3614065000,Repair of lip and border,1868.0,934.0,212.62,2540.48,32
CDM,3614125200,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",1211.0,605.5,212.62,1646.96,32
CDM,3614180000,"Drainage of abscess, cyst, or blood accumulation of dental bone",605.0,302.5,171.32,822.8,32
CDM,3614189900,Other procedure on teeth and gums,800.0,400.0,240.0,1591.79,32
CDM,3614200000,Drainage of abscess of roof of mouth,734.0,367.0,212.62,998.24,32
CDM,3614214000,Removal of soft tissue of roof of mouth,9729.0,4864.5,2918.7,13231.44,32
CDM,3614280900,Removal of foreign body in throat,830.0,415.0,212.62,1128.8,32
CDM,3614376100,Repositioning of oral or nasal feeding tube in small bowel,1975.0,987.5,321.7,2686.0,32
CDM,3614376200,Replacement of stomach stoma tube,1184.0,592.0,321.7,1610.24,32
CDM,3614510000,Biopsy of anal and/or rectal wall through anus,7599.0,3799.5,1805.07,10334.64,32
CDM,3614591500,Removal of impacted stool or foreign body in rectum under anesthesia,2417.0,1208.5,725.1,3287.12,32
CDM,3614604000,Drainage of deep abscess in rectum,5115.0,2557.5,1534.5,6956.4,32
CDM,3614605000,Drainage of superficial rectal abscess surrounding anus,3265.0,1632.5,979.5,4440.4,32
CDM,3614608300,Incision of external hemorrhoid with blood clot,699.0,349.5,209.7,1913.38,32
CDM,3614622000,Removal of single external noncancer growth of anus,4882.0,2441.0,1464.6,6639.52,32
CDM,3614632000,Removal of external hemorrhoid with blood clot,4760.0,2380.0,1428.0,6473.6,32
CDM,3614908200,Drainage of fluid from abdominal cavity,2098.0,1049.0,629.4,2853.28,32
CDM,3614908300,Drainage of fluid from abdominal cavity using imaging guidance,2605.0,1302.5,781.5,3542.8,32
CDM,3615170500,Simple change of bladder tube,772.0,386.0,108.16,1049.92,32
CDM,3615171000,Complicated change of bladder tube,1529.0,764.5,458.7,2079.44,32
CDM,3615422000,Injection of drug into erectile tissue at sides and back of penis,963.0,481.5,108.16,1309.68,32
CDM,3615423500,Injection procedure to cause erection,1045.0,522.5,108.16,1421.2,32
CDM,3615445000,Repositioning of foreskin including scar tissue removal,609.0,304.5,182.7,828.24,32
CDM,3615470000,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",4392.0,2196.0,1317.6,5973.12,32
CDM,3615510000,Drainage of abscess of scrotum,3875.0,1937.5,1162.5,5270.0,32
CDM,3615640500,Incision and drainage of abscess of external female genitals,1637.0,818.5,265.17,2226.32,32
CDM,3615642000,Incision and drainage of abscess of female genital gland,826.0,413.0,247.8,1123.36,32
CDM,3615710001,Simple biopsy of vaginal mucous membrane,3438.0,1719.0,667.43,4675.68,32
CDM,3615741500,Removal of impacted foreign body in vagina under anesthesia,7094.0,3547.0,2128.2,9647.84,32
CDM,3615812000,Dilation and scraping of uterus,7648.0,3824.0,2294.4,10401.28,32
CDM,3615830000,Insertion of IUD for pregnancy prevention,1502.0,751.0,265.17,2042.72,32
CDM,3615830100,Removal of IUD,901.0,450.5,265.17,1225.36,32
CDM,3615907400,Drainage of fetal fluid using ultrasound guidance,476.0,238.0,142.8,647.36,32
CDM,3615920000,Insertion of dilator device into cervix,1150.0,575.0,345.0,1564.0,32
CDM,3615941200,Turning of fetus through external manipulation,5464.0,2732.0,724.12,7431.04,32
CDM,3615981200,Treatment of miscarriage,7094.0,3547.0,2128.2,9647.84,32
CDM,3615984000,Induced abortion by dilation and scraping of uterine,9334.0,4667.0,2170.29,12694.24,32
CDM,3615984100,Induced abortion by dilation,6350.0,3175.0,1905.0,8636.0,32
CDM,3615987100,Removal of suture of cervix under anesthesia,4972.0,2486.0,1491.6,6761.92,32
CDM,3615989900,Other maternity care and delivery procedure,344.0,172.0,103.2,767.57,32
CDM,3615989901,Other maternity care and delivery procedure,4048.0,2024.0,260.32,5505.28,32
CDM,3616066000,Destruction using heat of one or more nodules on one thyroid lobe,5453.0,2726.5,1635.9,7416.08,28
CDM,3616066100,Destruction using heat of one or more nodules on additional thyroid lobe,4457.0,2228.5,1337.1,6061.52,28
CDM,3616102601,Removal of cerebrospinal fluid from brain and injection of substance,1691.0,845.5,507.3,2299.76,32
CDM,3616227000,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,1821.0,910.5,546.3,2476.56,32
CDM,3616227200,Removal of cerebrospinal fluid with lower back spinal tap,1870.0,935.0,561.0,2543.2,32
CDM,3616227300,Injection of blood or blood clot into spinal canal,2063.0,1031.5,618.9,2805.68,32
CDM,3616440000,Injection of anesthetic agent and/or steroid into face nerve,1125.0,562.5,337.5,1530.0,32
CDM,3616440500,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,1250.0,625.0,375.0,1700.0,32
CDM,3616440800,Injection of anesthetic agent and/or steroid into vagus nerve,1227.0,613.5,368.1,1668.72,32
CDM,3616441800,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,1979.0,989.5,500.68,2691.44,32
CDM,3616442000,Injection of anesthetic agent and/or steroid into rib nerve,1538.0,769.0,461.4,2091.68,32
CDM,3616443000,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,2703.0,1351.5,810.9,3676.08,32
CDM,3616444500,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),2228.0,1114.0,500.68,3030.08,32
CDM,3616444700,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),2081.0,1040.5,624.3,2830.16,32
CDM,3616445000,Injection of anesthetic agent and/or steroid into other nerve or branch,1931.0,965.5,500.68,2626.16,32
CDM,3616446101,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, single site",2397.0,1198.5,719.1,3259.92,32
CDM,3616446600,Unilateral thoracic fascial plane block by injection(s),959.0,479.5,287.7,1304.24,28
CDM,3616446800,Bilateral thoracic fascial plane block by injection(s),1744.0,872.0,523.2,2371.84,28
CDM,3616447301,Unilateral lower extremity fascial plane block by injection(s),950.0,475.0,285.0,1292.0,28
CDM,3616448300,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",2199.0,1099.5,659.7,2990.64,32
CDM,3616449300,"Injection of lower or sacral spine facet joint using imaging guidance, single level",2388.0,1194.0,716.4,3247.68,32
CDM,3616499900,Other procedure on nervous system,966.0,483.0,289.8,1313.76,32
CDM,3616520500,Removal of foreign body from external eye (conjunctiva),595.0,297.5,94.55,809.2,32
CDM,3616522000,Removal of foreign body in cornea,845.0,422.5,94.55,1149.2,32
CDM,3616522200,Removal of foreign body in cornea using slit lamp,588.0,294.0,94.55,799.68,32
CDM,3616770000,Incision and drainage of abscess of eyelid,1241.0,620.5,362.6,1687.76,32
CDM,3616793000,Suture of recent wound of eyelid,5224.0,2612.0,1567.2,7104.64,32
CDM,3616793800,Removal of embedded foreign body in eyelid,1104.0,552.0,331.2,1501.44,32
CDM,3616900000,Simple drainage of abscess or blood accumulation of external ear,1574.0,787.0,212.62,2140.64,32
CDM,3616920000,Removal of foreign body in ear canal,428.0,214.0,128.4,582.08,28
CDM,3616943600,Incision of eardrum with placement of eardrum tube under general anesthesia,5095.0,2547.5,1528.5,6929.2,32
CDM,3671004,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",499.0,249.5,149.7,678.64,32
CDM,3673033,"ANTI-INHIBITOR, PER I.U.",7.0,3.5,2.1,5897.78,31
CDM,3673050,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",6.0,3.0,1.8,5897.78,31
CDM,3673051,"INJECTION, RHO(D) IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC), INTRAMUSCULAR OR INTRAVENOUS, 100 IU",45.0,22.5,7.97,128.98,32
CDM,3673056,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1026.0,513.0,157.19,1395.36,32
CDM,3673058,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2430.0,1215.0,346.65,3304.8,32
CDM,3673080,"INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U.",2.0,1.0,0.6,2382.19,31
CDM,3700000001,HB OBSTETRIC ANESTHESIA EPIDURAL,629.0,314.5,157.25,415.14,16
CDM,3700001,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3700002,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,3700004,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3700015,HB ANES MAC 1ST 60M,3117.0,1558.5,779.25,2057.22,16
CDM,3700016,HB ANES MAC EA ADD 30M,1450.0,725.0,362.5,957.0,16
CDM,3709915100,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3709915200,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3709915300,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,3709915500,"Use of a drug to induce depression of consciousness by physician not performing a procedure (younger than 5 years), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3709915600,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,3709915700,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,3900901100,"BLOOD, SPLIT UNIT",165.0,82.5,49.5,224.4,32
CDM,3900901200,"CRYOPRECIPITATE, EACH UNIT",136.0,68.0,40.8,367.45,32
CDM,3900901600,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",499.0,249.5,149.7,678.64,32
CDM,3900901700,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",305.0,152.5,91.5,414.8,32
CDM,3900903100,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",331.0,165.5,99.3,450.16,32
CDM,3900903300,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",582.0,291.0,174.6,791.52,32
CDM,3900903500,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1643.0,821.5,346.65,2234.48,32
CDM,3900903501,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1920.0,960.0,346.65,2611.2,32
CDM,3900903700,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2430.0,1215.0,346.65,3304.8,32
CDM,3900904000,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1026.0,513.0,157.19,1395.36,32
CDM,3900905400,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1204.0,602.0,157.19,1637.44,32
CDM,3900905700,"RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1313.0,656.5,157.19,1785.68,32
CDM,3900905900,"FRESH FROZEN PLASMA BETWEEN 8-24 HOURS OF COLLECTION, EACH UNIT",194.0,97.0,58.2,263.84,32
CDM,3900907300,"PLATELETS, PHERESIS, PATHOGEN-REDUCED, EACH UNIT",1964.0,982.0,346.65,2671.04,32
CDM,3913643000,Transfusion of blood or blood products,1304.0,652.0,391.2,1773.44,32
CDM,4027660400,Ultrasound scan of chest,685.0,342.5,81.86,931.6,32
CDM,4027670500,Limited ultrasound scan of abdomen,1063.0,531.5,89.71,1445.68,32
CDM,4027677500,Limited ultrasound scan behind abdominal cavity,864.0,432.0,53.88,1175.04,32
CDM,4027681500,Limited ultrasound of pregnant uterus,821.0,410.5,88.59,1116.56,32
CDM,4027681700,Vaginal ultrasound of pregnant uterus,799.0,399.5,109.11,1086.64,32
CDM,4027681800,Ultrasound and monitoring of heart of fetus,1691.0,845.5,100.92,2299.76,32
CDM,4027681900,Ultrasound scan of fetus,1496.0,748.0,90.91,2034.56,32
CDM,4027683000,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",1028.0,514.0,95.32,1398.08,32
CDM,4027688200,Limited ultrasound scan of joint or other extremity structure except blood vessels,789.0,394.5,21.4,1073.04,32
CDM,4027693701,Ultrasonic guidance for blood vessel access,715.0,357.5,54.02,972.4,32
CDM,4091012,"Therapy procedure for nutrition management, each 15 minutes",97.0,48.5,29.1,220.89,32
CDM,4091013,"Therapy procedure reassessment for nutrition management, each 15 minutes",85.0,42.5,25.5,220.89,32
CDM,4091014,"Therapy procedure for nutrition management with group, each 30 minutes",72.0,36.0,15.41,220.89,32
CDM,4109464000,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,32
CDM,4109464200,Inhalation treatment for pneumonia,582.0,291.0,72.29,791.52,32
CDM,4109466400,Evaluation of use of breathing device,424.0,212.0,13.7,576.64,32
CDM,4109466700,Initial therapy service to facilitate lung function,297.0,148.5,72.29,403.92,32
CDM,4109478000,"Test of car seat or bed (1 year or younger), 1 hour",230.0,115.0,48.09,312.8,32
CDM,4109478100,"Test of car seat or bed (1 year or younger), each additional 30 minutes",115.0,57.5,34.5,156.4,32
CDM,4184006,Manual attempt to restore blood circulation and breathing,1374.0,687.0,278.02,1868.64,32
CDM,4184009,Transfusion of blood or blood products,1304.0,652.0,391.2,1773.44,32
CDM,4184019,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",159.0,79.5,47.7,104.94,28
CDM,4184031,Emergency department visit with high level of medical decision making,4297.0,2148.5,766.8,5843.92,28
CDM,4184032,Emergency department visit with moderate level of medical decision making,3495.0,1747.5,537.27,4753.2,28
CDM,4184033,Emergency department visit with low level of medical decision making,2349.0,1174.5,351.48,3194.64,28
CDM,4184034,Emergency department visit with straightforward medical decision making,1003.0,501.5,197.7,1364.08,28
CDM,4184035,Emergency department visit for problem that may not require health care professional,515.0,257.5,108.57,700.4,28
CDM,4184038,Insertion of stomach tube and aspiration of stomach contents,688.0,344.0,206.4,935.68,28
CDM,4184054,"VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER HCPCS VISION CODE",2.0,1.0,0.6,10.69,28
CDM,4184074,"SHOULDER ORTHOSIS, VEST TYPE ABDUCTION RESTRAINER, CANVAS WEBBING TYPE OR EQUAL, PREFABRICATED, OFF-THE-SHELF",181.0,90.5,54.3,266.98,28
CDM,4184099,"Critical care, first 30-74 minutes",4974.0,2487.0,1063.6,6764.64,28
CDM,4184100,"ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT",246.0,123.0,73.8,421.06,28
CDM,4184104,Emergent insertion of breathing tube into windpipe using an endoscope,920.0,460.0,276.0,1251.2,32
CDM,4184105,Emergent incision of windpipe for insertion of breathing tube,2750.0,1375.0,304.97,3740.0,32
CDM,4184112,Injection of drug or substance under skin or into muscle,233.0,116.5,58.14,316.88,32
CDM,4184113,Injection of drug or substance into vein,528.0,264.0,58.14,718.08,32
CDM,4184117,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,1821.0,910.5,546.3,2476.56,32
CDM,4184119,Simple bladder irrigation and/or instillation,1033.0,516.5,108.16,1404.88,32
CDM,4184124,Application of nonmoveable finger splint,435.0,217.5,35.89,591.6,32
CDM,4184126,Application of short leg cast,874.0,437.0,82.98,1188.64,32
CDM,4184128,Routine electrocardiogram (ECG) using at least 12 leads with tracing,453.0,226.5,32.27,616.08,32
CDM,4184129,Temporary pacemaker to regulate heart beat,1930.0,965.0,579.0,2624.8,32
CDM,4184132,Removal of foreign body in throat,830.0,415.0,212.62,1128.8,32
CDM,4184133,Diagnostic exam of voice box using an endoscope with mirror,685.0,342.5,205.5,931.6,32
CDM,4184136,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",847.0,423.5,228.76,1151.92,32
CDM,4184137,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",972.0,486.0,228.76,1321.92,32
CDM,4184138,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",1135.0,567.5,228.76,1543.6,32
CDM,4184139,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",891.0,445.5,228.76,1211.76,32
CDM,4184140,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",948.0,474.0,228.76,1289.28,32
CDM,4184141,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1168.0,584.0,228.76,1588.48,32
CDM,4184142,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",1037.0,518.5,311.1,1410.32,32
CDM,4184143,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",1367.0,683.5,410.1,1859.12,32
CDM,4184144,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",1680.0,840.0,479.14,2284.8,32
CDM,4184145,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",1764.0,882.0,479.14,2399.04,32
CDM,4184146,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",1185.0,592.5,355.5,1611.6,32
CDM,4184147,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",1293.0,646.5,387.9,1758.48,32
CDM,4184148,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1384.0,692.0,415.2,1882.24,32
CDM,4184149,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",1531.0,765.5,212.62,2082.16,32
CDM,4184150,"Repair of lacerated back 1/3 of tongue, 2.5 cm or less",898.0,449.0,212.62,1221.28,32
CDM,4184151,Simple or single drainage of skin abscess,1096.0,548.0,207.21,1490.56,32
CDM,4184153,Simple drainage of cyst of tailbone,1332.0,666.0,207.21,1811.52,32
CDM,4184155,Permanent removal fingernail or toenail,1307.0,653.5,392.1,1777.52,32
CDM,4184156,Removal of blood accumulation under fingernail or toenail,454.0,227.0,83.37,617.44,32
CDM,4184157,"Removal of foreign body from tissue, accessed beneath the skin, simple",1131.0,565.5,207.21,1538.16,32
CDM,4184160,"Removal of foreign body of foot tissue, accessed beneath the skin",2635.0,1317.5,527.72,3583.6,32
CDM,4184162,Aspiration and/or injection of fluid from medium joint,1110.0,555.0,308.97,1509.6,32
CDM,4184163,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,32
CDM,4184165,Closed treatment of dislocated shoulder with manipulation,1850.0,925.0,317.61,2516.0,32
CDM,4184166,Repair of dislocated elbow,938.0,469.0,281.4,1275.68,32
CDM,4184167,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",1038.0,519.0,311.4,1411.68,32
CDM,4184169,Closed treatment of dislocated knee,866.0,433.0,259.8,1177.76,32
CDM,4184170,Closed treatment of dislocated kneecap,891.0,445.5,267.3,1211.76,32
CDM,4184171,Closed treatment of dislocated ankle,1091.0,545.5,317.61,1483.76,32
CDM,4184172,Closed treatment of dislocated hip,969.0,484.5,290.7,1317.84,32
CDM,4184173,Closed treatment of broken great toe with manipulation,605.0,302.5,181.5,822.8,32
CDM,4184174,Closed treatment of broken finger or thumb at midportion or part near hand,722.0,361.0,216.6,981.92,32
CDM,4184175,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,932.0,466.0,279.6,1267.52,32
CDM,4184176,Closed treatment of broken great toe,516.0,258.0,154.8,701.76,32
CDM,4184177,Closed treatment of broken toe,778.0,389.0,233.4,1058.08,32
CDM,4184198,Application of lower and upper arm splint,865.0,432.5,71.76,1176.4,32
CDM,4184199,Application of nonmoveable forearm to hand splint,769.0,384.5,49.33,1045.84,32
CDM,4184201,Application of long leg splint from thigh to ankle or toe,516.0,258.0,79.62,701.76,32
CDM,4184202,Application of short leg splint from calf to foot,821.0,410.5,60.55,1116.56,32
CDM,4184203,Placement of strapping to elbow or wrist,372.0,186.0,75.96,505.92,32
CDM,4184204,Placement of strapping to hand or finger,356.0,178.0,37.0,484.16,32
CDM,4184207,Placement of strapping to knee,441.0,220.5,47.09,599.76,32
CDM,4184208,Placement of strapping to ankle or foot,602.0,301.0,40.37,818.72,32
CDM,4184209,Placement of strapping to toes,374.0,187.0,38.12,508.64,32
CDM,4184210,Placement of strapping to shoulder,351.0,175.5,59.43,477.36,32
CDM,4184213,"Removal or cutting of gauntlet, boot, or body cast",555.0,277.5,45.98,754.8,32
CDM,4184215,Reviving newborn at delivery,1650.0,825.0,495.0,2244.0,32
CDM,4184216,Removal of foreign body in cornea,845.0,422.5,94.55,1149.2,32
CDM,4184217,Removal of foreign body in cornea using slit lamp,588.0,294.0,94.55,799.68,32
CDM,4184218,Removal of foreign body from external eye (conjunctiva),595.0,297.5,94.55,809.2,32
CDM,4184219,Removal of foreign body from external eye (conjunctiva or sclera),796.0,398.0,94.55,1082.56,32
CDM,4184221,Removal of foreign body in nose,347.0,173.5,104.1,471.92,32
CDM,4184222,Simple control of nose bleed,779.0,389.5,171.32,1059.44,32
CDM,4184223,Complex control of nose bleed,857.0,428.5,171.32,1165.52,32
CDM,4184224,Initial control of nose bleed and insertion of packing,863.0,431.5,171.32,1173.68,32
CDM,4184225,Removal of impacted ear wax,253.0,126.5,75.9,344.08,28
CDM,4184226,Removal of foreign body in ear canal,428.0,214.0,128.4,582.08,28
CDM,4184227,Insertion of non-tunneled central venous tube for infusion (5 years or older),4922.0,2461.0,1377.13,6693.92,32
CDM,4184230,Vaginal delivery,7460.0,3730.0,2238.0,10145.6,32
CDM,4184234,Closed treatment of broken hand bone with manipulation,1148.0,574.0,317.61,1561.28,32
CDM,4184236,External shock to heart to regulate heart beat,2956.0,1478.0,777.75,4020.16,32
CDM,4184237,Insertion of needle for infusion into bone,861.0,430.5,258.3,1170.96,32
CDM,4184239,Closed treatment of broken base of forearm bone on small finger side at wrist,849.0,424.5,254.7,1154.64,32
CDM,4184241,Closed treatment of broken middle or upper end of outside lower leg bone,999.0,499.5,299.7,1358.64,32
CDM,4184242,Drainage of abscess near tonsil,1244.0,622.0,212.62,1691.84,32
CDM,4184243,"Simple separation of fingernail or toenail from nail bed, first nail",619.0,309.5,83.37,841.84,32
CDM,4184247,Drainage of blood or fluid accumulation,4113.0,2056.5,1233.9,5593.68,32
CDM,4184249,Repair of groin hernia that is not trapped,8755.0,4377.5,2626.5,11906.8,32
CDM,4184250,Simple closure of surface wound reopening,1404.0,702.0,421.2,1909.44,32
CDM,4184251,Closed treatment of dislocated finger joint with manipulation,913.0,456.5,273.9,1241.68,32
CDM,4184253,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4184254,Closed treatment of dislocated jaw joint,716.0,358.0,212.62,973.76,32
CDM,4184255,Insertion of temporary bladder tube,479.0,239.5,108.16,651.44,32
CDM,4184256,Simple insertion of temporary bladder tube,344.0,172.0,103.2,467.84,32
CDM,4184259,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),4922.0,2461.0,1377.13,6693.92,32
CDM,4184261,"Infusion into a vein for hydration, 31-60 minutes",663.0,331.5,198.9,901.68,32
CDM,4184262,"Infusion into a vein for hydration, each additional hour",445.0,222.5,60.29,613.94,32
CDM,4184263,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",950.0,475.0,273.88,1292.0,32
CDM,4184264,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",545.0,272.5,60.29,741.2,32
CDM,4184265,Injection of additional new drug or substance into vein,377.0,188.5,58.14,512.72,32
CDM,4184266,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,4184267,Complicated insertion of bladder tube,642.0,321.0,108.16,873.12,32
CDM,4184268,Incision and drainage of abscess of female genital gland,826.0,413.0,247.8,1123.36,32
CDM,4184269,Drainage of superficial rectal abscess surrounding anus,3265.0,1632.5,979.5,4440.4,32
CDM,4184270,Incision and drainage of abscess of external female genitals,1637.0,818.5,265.17,2226.32,32
CDM,4184271,Simple drainage of abscess of finger,837.0,418.5,207.21,1138.32,32
CDM,4184274,Complicated or multiple drainage of skin abscess,1403.0,701.5,207.21,1908.08,32
CDM,4184276,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",1250.0,625.0,375.0,1700.0,32
CDM,4184279,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,3723.0,1861.5,577.3,5063.28,32
CDM,4184280,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,3749.0,1874.5,577.3,5098.64,32
CDM,4184283,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,32
CDM,4184284,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,32
CDM,4184285,Injection of additional drug or substance into vein provided in a facility,298.0,149.0,58.14,405.28,32
CDM,4184287,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",44.0,22.0,13.2,111.52,28
CDM,4184288,Closed treatment of 3 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,32
CDM,4184289,Injection of agent to destroy nerve to internal sphincter of anus,3563.0,1781.5,1068.9,4845.68,32
CDM,4184300,"Inhalation treatment for acute airway obstruction, first hour",348.0,174.0,72.29,473.28,32
CDM,4184302,Closed treatment of broken toe with manipulation,850.0,425.0,255.0,1156.0,32
CDM,4184303,Closed treatment of broken outside lower leg bone at ankle with manipulation,1218.0,609.0,317.61,1656.48,32
CDM,4184304,Closed treatment of inside portion of shin bone at ankle with manipulation,3611.0,1805.5,577.3,4910.96,32
CDM,4184305,Closed treatment of 2 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,32
CDM,4184306,Closed treatment of broken shin bone with traction,5073.0,2536.5,577.3,6899.28,32
CDM,4184307,Closed treatment of middle part of broken shin bone with manipulation,4874.0,2437.0,577.3,6628.64,32
CDM,4184309,"Aspiration of abscess, blood, or cyst",925.0,462.5,207.21,1258.0,32
CDM,4184311,Closed treatment of dislocated hand joint at base of finger with manipulation,951.0,475.5,285.3,1293.36,32
CDM,4184312,Removal of skin of fingernail or toenail,890.0,445.0,83.37,1210.4,32
CDM,4184313,Removal of IUD,901.0,450.5,265.17,1225.36,32
CDM,4184314,Simple removal of embedded foreign body in mouth,1900.0,950.0,570.0,2584.0,32
CDM,4184315,Closed treatment of dislocated joint in toe,938.0,469.0,281.4,1275.68,32
CDM,4184316,"Dressing change or removal of burn tissue, less than 5% of total body surface",673.0,336.5,201.9,915.28,32
CDM,4184317,"Drainage of abscess, cyst, or blood accumulation of dental bone",605.0,302.5,171.32,822.8,32
CDM,4184318,Drainage of abscess of scrotum,3875.0,1937.5,1162.5,5270.0,32
CDM,4184321,First degree burn treatment,483.0,241.5,144.9,656.88,32
CDM,4184323,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",4392.0,2196.0,1317.6,5973.12,32
CDM,4184324,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",1385.0,692.5,228.76,1883.6,32
CDM,4184325,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1235.0,617.5,228.76,1679.6,32
CDM,4184326,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1297.0,648.5,228.76,1763.92,32
CDM,4184327,Simple drainage of abscess or blood accumulation of external ear,1574.0,787.0,212.62,2140.64,32
CDM,4184329,Repair of lip and border,1868.0,934.0,212.62,2540.48,32
CDM,4184330,Repair of fingernail or toenail bed,1126.0,563.0,83.37,1531.36,32
CDM,4184333,"Dressing change or removal of burn tissue, 5-10% of total body surface",750.0,375.0,225.0,1020.0,32
CDM,4184334,"Dressing change or removal of burn tissue, more than 10% of total body surface",935.0,467.5,280.5,1271.6,32
CDM,4184335,"Repair of lacerated mouth, 2.5 cm or less",761.0,380.5,212.62,1034.96,32
CDM,4184336,"Removal of skin and tissue, 20.0 sq cm or less",1980.0,990.0,479.14,2692.8,32
CDM,4184339,Complicated drainage of cyst of tailbone,1950.0,975.0,585.0,2652.0,32
CDM,4184341,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",1558.0,779.0,228.76,2118.88,32
CDM,4184346,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",1008.0,504.0,302.4,1370.88,32
CDM,4184351,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1437.0,718.5,431.1,1954.32,32
CDM,4184368,Complicated drainage of abscess in finger,3013.0,1506.5,903.9,4097.68,32
CDM,4184375,Closed treatment of broken end of finger or thumb with manipulation,825.0,412.5,247.5,1122.0,32
CDM,4184376,Closed treatment of dislocated hip prosthesis,1101.0,550.5,317.61,1497.36,32
CDM,4184377,Closed treatment of broken thigh bone at midportion with manipulation,4192.0,2096.0,577.3,5701.12,32
CDM,4184384,Removal of fluid from between lung and chest cavity,2672.0,1336.0,801.6,3633.92,32
CDM,4184388,"Simple drainage of abscess, cyst, or blood accumulation of mouth",1100.0,550.0,330.0,1591.79,32
CDM,4184392,Simple change of bladder tube,772.0,386.0,108.16,1049.92,32
CDM,4184396,Injection of anesthetic agent and/or steroid into face nerve,1125.0,562.5,337.5,1530.0,32
CDM,4184402,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",678.0,339.0,92.71,922.08,32
CDM,4184403,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",526.0,263.0,157.8,715.36,32
CDM,4184404,"Critical care, each additional 30 minutes",1071.0,535.5,321.3,1456.56,28
CDM,4184414,"Other procedure on throat, adenoids, or tonsils",622.0,311.0,186.6,2640.53,32
CDM,4184415,Closed treatment of broken finger or hand at base of finger with manipulation,2752.0,1376.0,577.3,3742.72,32
CDM,4184417,Injection of anesthetic agent and/or steroid into other nerve or branch,1931.0,965.5,500.68,2626.16,32
CDM,4184420,Drainage of deep abscess in rectum,5115.0,2557.5,1534.5,6956.4,32
CDM,4184422,Aspiration of fluid from chest cavity using imaging guidance,2219.0,1109.5,665.7,3017.84,32
CDM,4184423,Application of hinged finger splint,238.0,119.0,48.22,323.68,32
CDM,4184426,Repair of dislocated elbow under anesthesia,4874.0,2437.0,1211.37,6628.64,32
CDM,4184427,Removal of impacted ear wax by washing,225.0,112.5,67.5,306.0,28
CDM,4184473,Closed treatment of broken midpart of both forearm bones with manipulation,2761.0,1380.5,577.3,3754.96,32
CDM,4184478,Closed treatment of dislocated forearm bone at wrist with manipulation,1268.0,634.0,317.61,1724.48,32
CDM,4184554,Closed treatment of dislocated joint between toe and foot,708.0,354.0,212.4,962.88,32
CDM,4184555,Closed treatment of dislocated joint between toe and foot under anesthesia,4500.0,2250.0,1211.37,6120.0,32
CDM,4184560,Application of finger cast,520.0,260.0,156.0,707.2,32
CDM,4184571,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",1211.0,605.5,212.62,1646.96,32
CDM,4184580,Drainage of heart sac using imaging guidance,2948.0,1474.0,884.4,4009.28,32
CDM,4184586,Ultrasound scan of eye for foreign body localization,281.0,140.5,70.21,382.16,32
CDM,4184589,Repair of vertical lip wound extending to half of lip,1563.0,781.5,212.62,2125.68,32
CDM,4409260700,"Evaluation with prescription of speech-generating and alternative communication device, first hour",374.0,187.0,112.2,508.64,32
CDM,4501600000,First degree burn treatment,483.0,241.5,144.9,656.88,32
CDM,4502148000,Closed treatment of dislocated jaw joint,716.0,358.0,212.62,973.76,32
CDM,4502148500,Complicated repair of dislocated jaw joint with placement of stabilizing device,4522.0,2261.0,1211.37,6149.92,32
CDM,4502352000,Closed treatment of dislocated joint between collar and chest bone,3575.0,1787.5,577.3,4862.0,32
CDM,4502362500,Closed treatment of upper arm bone broken at shoulder joint with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502365000,Closed treatment of dislocated shoulder with manipulation,1850.0,925.0,317.61,2516.0,32
CDM,4502365500,Closed treatment of dislocated shoulder with manipulation under anesthesia,5243.0,2621.5,1211.37,7130.48,32
CDM,4502450500,Closed treatment of broken middle part of upper arm bone with manipulation,3575.0,1787.5,577.3,4862.0,32
CDM,4502453500,Closed treatment of upper arm bone broken at elbow with manipulation,3575.0,1787.5,577.3,4862.0,32
CDM,4502456500,Closed treatment of broken outer part of upper arm bone at elbow with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502460000,Repair of dislocated elbow,938.0,469.0,281.4,1275.68,32
CDM,4502460500,Repair of dislocated elbow under anesthesia,4874.0,2437.0,1211.37,6628.64,32
CDM,4502462000,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502464000,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",1038.0,519.0,311.4,1411.68,32
CDM,4502499900,Other procedure on upper arm or elbow,750.0,375.0,225.0,1020.0,32
CDM,4502552000,Closed treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint,4766.0,2383.0,577.3,6481.76,32
CDM,4502553000,Closed treatment of broken midpart of forearm bone on small finger side,750.0,375.0,225.0,1020.0,32
CDM,4502556500,Closed treatment of broken midpart of both forearm bones with manipulation,2761.0,1380.5,577.3,3754.96,32
CDM,4502560000,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,985.0,492.5,295.5,1339.6,32
CDM,4502560500,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,3749.0,1874.5,577.3,5098.64,32
CDM,4502563500,Closed treatment of other broken wrist bone with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502566000,Closed treatment of dislocated wrist bones with manipulation,763.0,381.5,228.9,1037.68,32
CDM,4502567500,Closed treatment of dislocated forearm bone at wrist with manipulation,1268.0,634.0,317.61,1724.48,32
CDM,4502569000,Closed treatment of dislocated wrist (lunate) bone with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502660500,Closed treatment of broken hand bone with manipulation,1148.0,574.0,317.61,1561.28,32
CDM,4502667000,Closed treatment of dislocated hand bone at wrist joint with manipulation,874.0,437.0,262.2,1188.64,32
CDM,4502670000,Closed treatment of dislocated hand joint at base of finger with manipulation,951.0,475.5,285.3,1293.36,32
CDM,4502672500,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,932.0,466.0,279.6,1267.52,32
CDM,4502675500,Closed treatment of broken end of finger or thumb with manipulation,825.0,412.5,247.5,1122.0,32
CDM,4502677000,Closed treatment of dislocated finger joint with manipulation,913.0,456.5,273.9,1241.68,32
CDM,4502677500,Closed treatment of dislocated finger joint with manipulation under anesthesia,980.0,490.0,294.0,1332.8,32
CDM,4502723800,Closed treatment of broken below neck of thigh bone,3528.0,1764.0,577.3,4798.08,32
CDM,4502725000,Closed treatment of dislocated hip,969.0,484.5,290.7,1317.84,32
CDM,4502726500,Closed treatment of dislocated hip prosthesis,1101.0,550.5,317.61,1497.36,32
CDM,4502755000,Closed treatment of dislocated knee,866.0,433.0,259.8,1177.76,32
CDM,4502756000,Closed treatment of dislocated kneecap,891.0,445.5,267.3,1211.76,32
CDM,4502775200,Closed treatment of middle part of broken shin bone with manipulation,4874.0,2437.0,577.3,6628.64,32
CDM,4502776200,Closed treatment of inside portion of shin bone at ankle with manipulation,3611.0,1805.5,577.3,4910.96,32
CDM,4502776800,Closed treatment of back portion of shin bone at ankle with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502778100,Closed treatment of broken middle or upper end of outside lower leg bone with manipulation,4666.0,2333.0,577.3,6345.76,32
CDM,4502778800,Closed treatment of broken outside lower leg bone at ankle with manipulation,1218.0,609.0,317.61,1656.48,32
CDM,4502781000,Closed treatment of 2 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,32
CDM,4502781800,Closed treatment of 3 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,32
CDM,4502782400,Closed treatment of broken shin bone at lower weight bearing joint,845.0,422.5,253.5,1149.2,32
CDM,4502782500,Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction,3131.0,1565.5,577.3,4258.16,32
CDM,4502784000,Closed treatment of dislocated ankle,1091.0,545.5,317.61,1483.76,32
CDM,4502843500,Closed treatment of broken ankle joint bone with manipulation,4766.0,2383.0,577.3,6481.76,32
CDM,4502849000,Closed treatment of broken great toe,516.0,258.0,154.8,701.76,32
CDM,4502849500,Closed treatment of broken great toe with manipulation,605.0,302.5,181.5,822.8,32
CDM,4502851000,Closed treatment of broken toe,778.0,389.0,233.4,1058.08,32
CDM,4502851500,Closed treatment of broken toe with manipulation,850.0,425.0,255.0,1156.0,32
CDM,4502860000,Closed treatment of dislocated midfoot joint,699.0,349.5,209.7,950.64,32
CDM,4502863500,Closed treatment of dislocated joint between toe and foot under anesthesia,4500.0,2250.0,1211.37,6120.0,32
CDM,4502866000,Closed treatment of dislocated joint in toe,938.0,469.0,281.4,1275.68,32
CDM,4502866500,Closed treatment of dislocated joint in toe under anesthesia,985.0,492.5,295.5,1339.6,32
CDM,4502910500,Application of lower and upper arm splint,865.0,432.5,71.76,1176.4,32
CDM,4502912500,Application of nonmoveable forearm to hand splint,769.0,384.5,49.33,1045.84,32
CDM,4502913000,Application of nonmoveable finger splint,435.0,217.5,35.89,591.6,32
CDM,4502913100,Application of hinged finger splint,238.0,119.0,48.22,323.68,32
CDM,4502950500,Application of long leg splint from thigh to ankle or toe,516.0,258.0,79.62,701.76,32
CDM,4502951500,Application of short leg splint from calf to foot,821.0,410.5,60.55,1116.56,32
CDM,4502954000,Placement of strapping to ankle or foot,602.0,301.0,40.37,818.72,32
CDM,4503090600,Subsequent control of nosebleed and insertion of packing,755.0,377.5,212.62,1026.8,32
CDM,4504065200,Repair of vertical lip wound extending to half of lip,1563.0,781.5,212.62,2125.68,32
CDM,4504065400,Repair of vertical lip wound extending to over half of lip,4359.0,2179.5,1307.7,5928.24,32
CDM,4504080000,"Simple drainage of abscess, cyst, or blood accumulation of mouth",1100.0,550.0,330.0,1591.79,32
CDM,4504083000,"Repair of lacerated mouth, 2.5 cm or less",761.0,380.5,212.62,1034.96,32
CDM,4504083100,"Repair of lacerated mouth, more than 2.5 cm",1521.0,760.5,456.3,2068.56,32
CDM,4504100800,"Drainage of abscess, cyst, or blood accumulation under jaw bone from inside mouth",6694.0,3347.0,1755.59,9103.84,32
CDM,4504125000,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",1531.0,765.5,212.62,2082.16,32
CDM,4506793500,Repair of wound of eyelid margin,5905.0,2952.5,1659.96,8030.8,32
CDM,4509929100,"Critical care, first 30-74 minutes",4974.0,2487.0,1063.6,6764.64,28
CDM,4509929200,"Critical care, each additional 30 minutes",1071.0,535.5,321.3,1456.56,28
CDM,4609401000,Test to measure expiratory airflow and volume,634.0,317.0,46.63,862.24,32
CDM,4609406000,Test to measure expiratory airflow and volume changes before and after medication administration,1083.0,541.5,75.59,1472.88,32
CDM,4609407000,Test to measure lung airway sensitivity,1618.0,809.0,100.95,2200.48,32
CDM,4609415000,Test to measure the total volume of air that can be exhaled after inhaling,342.0,171.0,18.81,465.12,32
CDM,4609437500,Test to measure rate of airflow,551.0,275.5,35.19,749.36,32
CDM,4609445200,Test to measure lung function at high altitude,411.0,205.5,72.29,558.96,32
CDM,4609445300,Test to measure lung function at high altitude with evaluation of oxygen needs at rest and during exercise,510.0,255.0,72.29,693.6,32
CDM,4609461700,Test for exercise-induced spasm of lung airways,600.0,300.0,72.29,816.0,32
CDM,4609461800,Test for exercise-induced lung stress,650.0,325.0,72.29,884.0,32
CDM,4609462100,Test for exercise-induced heart and lung stress,2375.0,1187.5,129.52,3230.0,32
CDM,4609472600,Test to determine lung volumes using sensors,939.0,469.5,52.02,1277.04,32
CDM,4609472700,Test to determine lung volumes using gas dilution or washout,666.0,333.0,55.36,905.76,32
CDM,4609472800,Test to measure resistance of the airways and lungs to differing frequencies,506.0,253.0,52.02,688.16,32
CDM,4609472900,Test to examine how well the lungs exchange gases,788.0,394.0,57.93,1071.68,32
CDM,4609479900,Other service or procedure on lung,451.0,225.5,22.33,613.36,32
CDM,4609479901,Other service or procedure on lung,376.0,188.0,22.33,511.36,32
CDM,4609501200,Test to measure the level of nitric oxide gas,313.0,156.5,48.09,425.68,32
CDM,4719255600,Test for ability to detect and repeat spoken words with speech recognition,205.0,102.5,38.31,278.8,32
CDM,4719262200,"Analysis, programming, and verification of sound processor for bone-anchored inner ear implant, first hour",425.0,212.5,127.5,578.0,28
CDM,4800571000,Insertion or replacement of implantable cardioverter-defibrillator system with electrodes under breastbone,99596.0,49798.0,27818.07,135450.56,30
CDM,4809295000,Manual attempt to restore blood circulation and breathing,1374.0,687.0,278.02,1868.64,32
CDM,4809296000,External shock to heart to regulate heart beat,2956.0,1478.0,777.75,4020.16,32
CDM,4809329800,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",369.0,184.5,48.05,501.84,32
CDM,4810795000,Transcatheter insertion of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular pacemaker components,57778.0,28889.0,9875.67,78578.08,32
CDM,4810823000,Insertion of permanent single-chamber leadless pacemaker for pacing the right upper heart chamber using imaging guidance,57838.0,28919.0,17351.4,78659.68,28
CDM,4813321000,Insertion of temporary pacemaker lead in single heart chamber,12941.0,6470.5,1968.66,17599.76,32
CDM,4813396800,Removal of blood flow assist device in aorta,2875.0,1437.5,862.5,9612.57,32
CDM,4819297200,Shockwave destruction of calcified plaque in coronary artery accessed through skin using catheter,7095.0,3547.5,2128.5,9649.2,28
CDM,4819350300,Insertion of tube in pulmonary artery for monitoring,2429.0,1214.5,728.7,3303.44,32
CDM,4819356900,"Injection for selective imaging of pulmonary artery during heart catheterization, on one side of body",1814.0,907.0,411.09,2467.04,32
CDM,4819357300,"Injection for selective imaging of pulmonary artery during heart catheterization, on both sides of body",2993.0,1496.5,411.09,4070.48,32
CDM,4819358700,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals above the heart,3835.0,1917.5,1150.5,5215.6,28
CDM,4819379901,Other cardiovascular service or procedure,512.0,256.0,32.27,696.32,32
CDM,4819379902,Other cardiovascular service or procedure,39104.0,19552.0,32.27,53181.44,32
CDM,4830001,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",4316.0,2158.0,543.5,5869.76,32
CDM,4839330800,"Ultrasound of heart, follow-up",889.0,444.5,116.62,1209.04,32
CDM,5051001,RECOVERY ROOM - GENERAL CLASSIFICATION,1766.0,883.0,441.5,1165.56,16
CDM,5051004,RECOVERY ROOM - GENERAL CLASSIFICATION,283.0,141.5,70.75,186.78,16
CDM,5051007,RECOVERY ROOM - GENERAL CLASSIFICATION,31.0,15.5,7.75,20.46,16
CDM,5100001,Complicated or multiple drainage of skin abscess,1403.0,701.5,207.21,1908.08,32
CDM,5100014,"Removal of fingernails or toenails, 6 or more nails",358.0,179.0,75.96,486.88,32
CDM,5100018,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",4259.0,2129.5,951.62,5792.24,32
CDM,5100019,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",2086.0,1043.0,479.14,2836.96,32
CDM,5100035,"Application of walking cast covering foot, ankle, and lower leg",1029.0,514.5,225.69,1399.44,32
CDM,5100036,"Strapping, Unna boot",474.0,237.0,84.1,644.64,32
CDM,5100037,"Application of vein wound compression bandages on lower leg, ankle, and foot",490.0,245.0,147.0,666.4,32
CDM,5100039,"Removal of tissue from wound, 20.0 sq cm or less",623.0,311.5,186.9,847.28,32
CDM,5100040,"Removal of tissue from wound, each additional 20.0 sq cm",597.0,298.5,25.18,1351.13,32
CDM,5100042,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",558.0,279.0,167.4,758.88,32
CDM,5100043,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",884.0,442.0,265.2,1202.24,32
CDM,5100050,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",2642.0,1321.0,792.6,3593.12,32
CDM,5100051,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",1114.0,557.0,334.2,2583.21,32
CDM,5100052,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",7560.0,3780.0,2268.0,10281.6,32
CDM,5100053,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",3110.0,1555.0,933.0,4229.6,32
CDM,5100054,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",3841.0,1920.5,951.62,5223.76,32
CDM,5100064,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",48.0,24.0,14.4,160.23,28
CDM,5100073,Biopsy of surface bone,9269.0,4634.5,2246.0,12605.84,32
CDM,5100078,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",12.0,6.0,3.6,160.23,28
CDM,5109755000,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community, initial 30 minutes",340.0,170.0,46.11,462.4,20
CDM,5109755100,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community, each additional 15 minutes",170.0,85.0,24.53,231.2,20
CDM,5109755200,Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community,170.0,85.0,10.79,231.2,20
CDM,5109921100,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,149.0,74.5,60.64,202.64,20
CDM,5109921200,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",164.0,82.0,66.75,223.04,20
CDM,5109921300,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",185.0,92.5,75.3,251.6,20
CDM,5109921400,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",215.0,107.5,87.51,292.4,20
CDM,5109921500,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",263.0,131.5,88.0,357.68,20
CDM,5153017,HB LACTATION CONSULTING LIMITED,120.0,60.0,30.0,79.2,16
CDM,5153018,HB LACTATION CONSULTING EXTENDED,166.0,83.0,41.5,109.56,16
CDM,5202001,LABOR ROOM/DELIVERY - CIRCUMCISION,682.0,341.0,170.5,450.12,16
CDM,5253002,Fetal contraction stress test,641.0,320.5,192.3,871.76,32
CDM,5254011,Fetal test,975.0,487.5,242.91,1326.0,32
CDM,5254026,Incision and drainage of abscess of external female genitals,1637.0,818.5,265.17,2226.32,32
CDM,5254027,Tying or incision of fallopian tubes during cesarean delivery or other abdominal surgery,2800.0,1400.0,840.0,3808.0,32
CDM,5254033,Scraping of lining of uterus after delivery,5060.0,2530.0,1518.0,6881.6,32
CDM,5254034,Insertion of dilator device into cervix,1150.0,575.0,345.0,1564.0,32
CDM,5254035,Episiotomy or repair of vagina,4972.0,2486.0,1491.6,6761.92,32
CDM,5254036,Suture of cervix during pregnancy through vagina,7620.0,3810.0,2125.76,10363.2,32
CDM,5254039,Turning of fetus through external manipulation,5464.0,2732.0,724.12,7431.04,32
CDM,5254040,Delivery of placenta,4972.0,2486.0,1491.6,6761.92,32
CDM,5254041,Cesarean delivery with removal of uterus,3600.0,1800.0,1080.0,5475.88,32
CDM,5254042,Treatment of miscarriage,7094.0,3547.0,2128.2,9647.84,32
CDM,5254046,Removal of suture of cervix under anesthesia,4972.0,2486.0,1491.6,6761.92,32
CDM,5254052,Vaginal delivery with care before and after delivery,8965.0,4482.5,2689.5,12192.4,32
CDM,5254054,Cesarean delivery with care before and after delivery,7629.0,3814.5,2288.7,10375.44,32
CDM,5254059,RECOVERY ROOM - GENERAL CLASSIFICATION,1421.0,710.5,355.25,937.86,16
CDM,5254060,RECOVERY ROOM - GENERAL CLASSIFICATION,479.0,239.5,119.75,316.14,16
CDM,5254061,Tying or incision of fallopian tubes during same hospitalization,3500.0,1750.0,1050.0,4760.0,32
CDM,5254077,Insertion of tube into ureter using an endoscope through bladder area,4392.0,2196.0,1317.6,5973.12,32
CDM,5254079,Other maternity care and delivery procedure,344.0,172.0,103.2,767.57,32
CDM,5254080,Removal of uterine tubes and ovaries,5092.0,2546.0,1527.6,6925.12,32
CDM,5254081,Pelvic exam under anesthesia,5469.0,2734.5,265.17,7437.84,32
CDM,5254084,"Test of car seat or bed (1 year or younger), 1 hour",230.0,115.0,48.09,312.8,32
CDM,5254092,Induced abortion by dilation,6350.0,3175.0,1905.0,8636.0,32
CDM,5254094,Vaginal delivery and care before and after delivery after previous cesarean delivery,8500.0,4250.0,2550.0,11560.0,32
CDM,5254096,Vaginal delivery,7460.0,3730.0,2238.0,10145.6,32
CDM,5254098,Removal of implantable contraceptive capsules,1684.0,842.0,505.2,2290.24,32
CDM,5254099,Incision and drainage of abscess of female genital gland,826.0,413.0,247.8,1123.36,32
CDM,5254101,Induced abortion by dilation and scraping of uterine,9334.0,4667.0,2170.29,12694.24,32
CDM,5254102,Other procedure on fetus,735.0,367.5,220.5,999.6,32
CDM,5832040,Tying of dilated veins of esophagus with bands using a flexible endoscope,3716.0,1858.0,1114.8,5053.76,32
CDM,5832066,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,1898.0,949.0,425.3,2581.28,32
CDM,5832069,Incision and drainage of vaginal blood accumulation following delivery,4475.0,2237.5,1342.5,6086.0,32
CDM,6042021,Electronic analysis of spinal canal drug infusion pump,737.0,368.5,178.73,1002.32,32
CDM,6042022,Electronic analysis and reprogramming of spinal canal drug infusion pump,1008.0,504.0,178.73,1370.88,32
CDM,6042023,Injection of drug or substance under skin or into muscle,233.0,116.5,58.14,316.88,32
CDM,6042038,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,367.0,183.5,110.1,530.72,32
CDM,6042044,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,1250.0,625.0,375.0,1700.0,32
CDM,6052016,"Needle measurement of electrical activity in arm or leg muscles, 1 extremity",711.0,355.5,62.91,966.96,32
CDM,6052017,"Needle measurement of electrical activity in arm or leg muscles, 2 extremities",736.0,368.0,92.03,1000.96,32
CDM,6052019,"Needle measurement of electrical activity in arm or leg muscles, 4 extremities",850.0,425.0,123.6,1156.0,32
CDM,6052023,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",900.0,450.0,166.38,1224.0,32
CDM,6052042,Testing of autonomic (sympathetic) nervous system function,576.0,288.0,166.38,783.36,32
CDM,6052043,Measurement of nerve conduction patterns of eye blink reflex,559.0,279.5,75.96,760.24,32
CDM,6052044,Exam of visual field with limited testing,272.0,136.0,75.96,369.92,32
CDM,6052045,Exam of visual field with intermediate testing,359.0,179.5,75.96,488.24,32
CDM,6052046,Exam of visual field with extended testing,430.0,215.0,94.55,584.8,32
CDM,6052050,Study of esophageal sensation by balloon distension,7030.0,3515.0,480.47,9560.8,32
CDM,6052058,Application of long leg cast from thigh to toe,932.0,466.0,154.75,1267.52,32
CDM,6052060,"Needle measurement of electrical activity in arm or leg muscles, limited study",594.0,297.0,166.38,807.84,32
CDM,6052061,"Needle measurement of electrical activity in arm or leg muscles, complete study",669.0,334.5,166.38,909.84,32
CDM,6052062,Needle measurement of electrical activity in trunk or head muscles,531.0,265.5,159.3,722.16,32
CDM,6052065,"Nerve conduction, 1-2 studies",685.0,342.5,166.38,931.6,32
CDM,6052066,"Nerve conduction, 3-4 studies",1233.0,616.5,166.38,1676.88,32
CDM,6052067,"Nerve conduction, 5-6 studies",1500.0,750.0,166.38,2040.0,32
CDM,6052068,"Nerve conduction, 7-8 studies",1687.0,843.5,166.38,2294.32,32
CDM,6052069,"Nerve conduction, 9-10 studies",2446.0,1223.0,166.38,3326.56,32
CDM,6052070,"Nerve conduction, 11-12 studies",2635.0,1317.5,166.38,3583.6,32
CDM,6052071,"Nerve conduction, 13 or more studies",2904.0,1452.0,166.38,3949.44,32
CDM,6052072,"Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt",487.0,243.5,146.1,662.32,32
CDM,6052074,"Continuous remote monitoring of nervous system during operation, each hour",313.0,156.5,93.9,425.68,28
CDM,6081001,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",29.0,14.5,7.16,604.48,31
CDM,6081002,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",42.0,21.0,12.6,604.48,31
CDM,6082016,Injection of chemical for paralysis of nerve muscles on side of face,1469.0,734.5,395.23,1997.84,32
CDM,6082039,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator",683.0,341.5,171.32,928.88,32
CDM,6082040,Administration and interpretation of patient-focused health risk assessment,99.0,49.5,28.93,134.64,24
CDM,6082043,Injection of chemical for paralysis of salivary glands on both sides of mouth,751.0,375.5,225.3,1021.36,32
CDM,6082044,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",29.0,14.5,8.7,604.48,31
CDM,6082045,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",16.0,8.0,4.8,604.48,31
CDM,6082046,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,1143.0,571.5,342.9,1554.48,32
CDM,6082047,Injection of chemical for paralysis of nerve muscles on side of voice box,1259.0,629.5,377.7,1712.24,32
CDM,6082048,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",1815.0,907.5,500.68,2468.4,32
CDM,6082049,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity",1025.0,512.5,307.5,1394.0,32
CDM,6082050,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity",1906.0,953.0,500.68,2592.16,32
CDM,6082051,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity",1128.0,564.0,338.4,1534.08,32
CDM,6082052,"Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles",1869.0,934.5,500.68,2541.84,32
CDM,6082053,"Injection of chemical for paralysis of nerve muscles on trunk, 6 or more muscles",2158.0,1079.0,500.68,2934.88,32
CDM,6082054,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,1558.0,779.0,395.23,2118.88,32
CDM,6082060,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.0,1.0,0.02,2.72,28
CDM,6082062,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",2692.0,1346.0,570.27,3661.12,32
CDM,6091002,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,6091003,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,6091038,Blood glucose (sugar) test performed by hand-held instrument,39.0,19.5,1.28,53.04,32
CDM,6091039,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,421.0,210.5,75.96,572.56,32
CDM,6091080,Removal of impacted ear wax,253.0,126.5,75.9,344.08,28
CDM,6091105,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",263.0,131.5,88.0,357.68,20
CDM,6091106,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",185.0,92.5,75.3,251.6,20
CDM,6091107,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,149.0,74.5,60.64,202.64,20
CDM,6091108,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",164.0,82.0,66.75,223.04,20
CDM,6091109,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",250.0,125.0,88.0,340.0,20
CDM,6091110,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",275.0,137.5,88.0,374.0,20
CDM,6091111,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",214.0,107.0,87.1,291.04,20
CDM,6091113,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",180.0,90.0,73.26,244.8,20
CDM,6091114,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",215.0,107.5,87.51,292.4,20
CDM,6091120,Transitional care management services for problem of at least moderate complexity,241.0,120.5,88.0,327.76,24
CDM,6091121,Transitional care management services for problem of high complexity,286.0,143.0,88.0,388.96,24
CDM,6091133,Insertion of temporary bladder tube,479.0,239.5,108.16,651.44,32
CDM,6091135,Urine pregnancy test,87.0,43.5,3.06,118.32,32
CDM,6091137,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,6091138,"Administration of vaccine, each additional vaccine",120.0,60.0,36.0,163.2,32
CDM,6091139,Hepatitis A vaccine adult dosage,243.0,121.5,26.68,330.48,32
CDM,6091146,Initial new patient preventive medicine evaluation (18-39 years),161.0,80.5,65.53,218.96,20
CDM,6091147,Initial new patient preventive medicine evaluation (40-64 years),215.0,107.5,87.51,292.4,20
CDM,6091148,Established patient periodic preventive medicine examination (18-39 years),163.0,81.5,66.34,221.68,20
CDM,6091149,Established patient periodic preventive medicine examination (40-64 years),177.0,88.5,72.04,240.72,20
CDM,6091150,Established patient periodic preventive medicine examination (65 year old or older),199.0,99.5,80.99,270.64,20
CDM,6091151,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,6091152,Measurement of liver stiffness,558.0,279.0,137.18,758.88,32
CDM,6091153,CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION,160.0,80.0,48.0,217.6,28
CDM,6091164,"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",106.0,53.0,20.82,144.16,32
CDM,6091165,Initial new patient preventive medicine evaluation (65 years or older),221.0,110.5,88.0,300.56,20
CDM,6091231,Ultrasound of within the brain blood flow for blood clots,1062.0,531.0,134.61,1444.32,32
CDM,6093046,"Extended office or other outpatient service by clinical staff, first hour",79.0,39.5,32.15,107.44,20
CDM,6093048,Removal of impacted ear wax by washing,225.0,112.5,67.5,306.0,28
CDM,6100086600,Quantitative MRI of the brain with comparison to previous MRI scan with MRI scan performed during the same visit,1854.0,927.0,307.22,2521.44,28
CDM,6106171500,"MRI guided high intensity focused ultrasound, computer-assisted destruction of intracranial tissue",37411.0,18705.5,625.0,50878.96,28
CDM,6183003,"Administration of chemotherapy into vein, 1 hour or less",1875.0,937.5,42.23,2550.0,32
CDM,6183004,"Administration of chemotherapy into vein, each additional hour",843.0,421.5,92.71,1146.48,32
CDM,6183005,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,713.0,356.5,58.14,969.68,32
CDM,6183018,Injection of drug or substance into vein,528.0,264.0,58.14,718.08,32
CDM,6183053,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",950.0,475.0,273.88,1292.0,32
CDM,6183054,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",545.0,272.5,60.29,741.2,32
CDM,6183057,Administration of chemotherapy into vein using push technique,933.0,466.5,58.14,1268.88,32
CDM,6183058,Injection of chemotherapy via reservoir under skin,763.0,381.5,58.14,1037.68,32
CDM,6183068,"Infusion into a vein for hydration, 31-60 minutes",663.0,331.5,198.9,901.68,32
CDM,6183069,"Infusion into a vein for hydration, each additional hour",445.0,222.5,60.29,613.94,32
CDM,6183071,Irrigation of implanted venous access drug delivery device,374.0,187.0,58.14,508.64,32
CDM,6183072,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,580.0,290.0,58.14,788.8,32
CDM,6183073,Injection of additional new drug or substance into vein,377.0,188.5,58.14,512.72,32
CDM,6183077,Administration of additional new drug or substance into vein using push technique,651.0,325.5,58.14,885.36,32
CDM,6183081,"Administration of chemotherapy into growth, 1-7",612.0,306.0,58.14,832.32,32
CDM,6183083,Application of on-body injector for under skin injection,263.0,131.5,58.14,357.68,32
CDM,6243041,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,1027.0,513.5,77.51,1396.72,32
CDM,6273004,Test for allergy using skin patch,120.0,60.0,36.0,1105.7,32
CDM,6273005,Test for allergy using allergenic extract,90.0,45.0,27.0,1105.7,32
CDM,6273012,Professional service for multiple injections of allergen,235.0,117.5,31.46,319.6,32
CDM,6273015,Professional service for single injection of allergen,188.0,94.0,31.46,255.68,32
CDM,6273021,Test for allergy using allergenic extract injected into skin,239.0,119.5,43.71,325.04,32
CDM,6273027,Professional service for preparation and provision of 1 or more antigens,127.0,63.5,31.46,172.72,32
CDM,6273033,Professional service for preparation and provision of 4 stinging insect venom,193.0,96.5,31.46,262.48,32
CDM,6273068,"INJECTION, OMALIZUMAB, 5 MG",119.0,59.5,35.7,1677.59,31
CDM,6273071,Test to measure the level of nitric oxide gas,313.0,156.5,48.09,425.68,32
CDM,6273074,Test for allergy using combination of methods with venom,269.0,134.5,37.24,365.84,32
CDM,6273075,Test for allergy using combination of methods with drug or biological,225.0,112.5,43.71,306.0,32
CDM,6273076,"Test for allergy using ingested items, initial 2 hours",1210.0,605.0,363.0,1645.6,32
CDM,6273077,"Test for allergy using ingested items, each additional hour",661.0,330.5,198.3,898.96,32
CDM,6302041,"Removal of skin tag, 1-15 skin tags",886.0,443.0,207.21,1204.96,32
CDM,6302095,Therapy procedure using ultraviolet radiation with tar or petroleum jelly application,405.0,202.5,45.25,550.8,32
CDM,6303269,"Complicated repair of wound of trunk, 2.6-7.5 cm",2039.0,1019.5,527.72,2773.04,32
CDM,6303270,"Complicated repair of wound of trunk, each additional 5.0 cm or less",1188.0,594.0,356.4,1615.68,32
CDM,6303271,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",1276.0,638.0,382.8,1735.36,32
CDM,6303272,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",1745.0,872.5,523.42,2373.2,32
CDM,6303273,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",741.0,370.5,222.3,1007.76,32
CDM,6303274,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",1419.0,709.5,425.7,1929.84,32
CDM,6303275,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",2099.0,1049.5,523.42,2854.64,32
CDM,6303276,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",674.0,337.0,202.2,916.64,32
CDM,6303278,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",2529.0,1264.5,527.72,3439.44,32
CDM,6303279,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",2734.0,1367.0,527.72,3718.24,32
CDM,6341001,"Removal of noncancer thickened skin growth, 1 growth",429.0,214.5,128.7,583.44,32
CDM,6341005,Acne surgery,415.0,207.5,124.5,564.4,30
CDM,6341012,"Removal of noncancer thickened skin growth, 2-4 growths",431.0,215.5,129.3,586.16,32
CDM,6341018,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",552.0,276.0,165.6,750.72,32
CDM,6341019,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",540.0,270.0,162.0,734.4,32
CDM,6341020,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",628.0,314.0,188.4,854.08,32
CDM,6341021,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",753.0,376.5,207.21,1024.08,32
CDM,6341022,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",535.0,267.5,160.5,727.6,32
CDM,6341023,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",558.0,279.0,167.4,758.88,32
CDM,6341024,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",580.0,290.0,174.0,788.8,32
CDM,6341025,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",825.0,412.5,207.21,1122.0,32
CDM,6341026,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",543.0,271.5,162.9,738.48,32
CDM,6341027,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",694.0,347.0,207.21,943.84,32
CDM,6341028,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",725.0,362.5,207.21,986.0,32
CDM,6341029,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",775.0,387.5,207.21,1054.0,32
CDM,6341030,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",1210.0,605.0,363.0,1645.6,32
CDM,6341031,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",1650.0,825.0,495.0,2244.0,32
CDM,6341032,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",2613.0,1306.5,527.72,3553.68,32
CDM,6341033,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",3025.0,1512.5,527.72,4114.0,32
CDM,6341034,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",4950.0,2475.0,1485.0,6732.0,32
CDM,6341035,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",5019.0,2509.5,1505.7,6825.84,32
CDM,6341036,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",2786.0,1393.0,835.8,3788.96,32
CDM,6341037,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",2860.0,1430.0,527.72,3889.6,32
CDM,6341038,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",3988.0,1994.0,1196.4,5423.68,32
CDM,6341039,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",4524.0,2262.0,1357.2,6152.64,32
CDM,6341040,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",4688.0,2344.0,1406.4,6375.68,32
CDM,6341041,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",6343.0,3171.5,1902.9,8626.48,32
CDM,6341042,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",1210.0,605.0,363.0,1645.6,32
CDM,6341043,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",2375.0,1187.5,527.72,3230.0,32
CDM,6341044,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",2750.0,1375.0,527.72,3740.0,32
CDM,6341045,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",3036.0,1518.0,910.8,4128.96,32
CDM,6341046,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",3170.0,1585.0,951.0,4311.2,32
CDM,6341047,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",4475.0,2237.5,1342.5,6086.0,32
CDM,6341049,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",1779.0,889.5,527.72,2419.44,32
CDM,6341050,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",2064.0,1032.0,523.42,2807.04,32
CDM,6341051,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",2390.0,1195.0,527.72,3250.4,32
CDM,6341052,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",3012.0,1506.0,903.6,4096.32,32
CDM,6341053,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",3749.0,1874.5,1124.7,5098.64,32
CDM,6341056,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",2874.0,1437.0,527.72,3908.64,32
CDM,6341062,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",2232.0,1116.0,527.72,3035.52,32
CDM,6341063,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",3408.0,1704.0,1022.4,4634.88,32
CDM,6341064,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",3611.0,1805.5,1083.3,4910.96,32
CDM,6341066,"Simple separation of fingernail or toenail from nail bed, first nail",619.0,309.5,83.37,841.84,32
CDM,6341070,Biopsy of fingernail or toenail,2177.0,1088.5,527.72,2960.72,32
CDM,6341072,"Injection into skin growth, 1-7 growths",950.0,475.0,207.21,1292.0,32
CDM,6341073,"Injection into skin growth, more than 7 growths",1219.0,609.5,207.21,1657.84,32
CDM,6341074,"Removal of growth under skin of back or lower sides, 3.0 cm or more",6610.0,3305.0,1983.0,8989.6,32
CDM,6341080,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",972.0,486.0,228.76,1321.92,32
CDM,6341086,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",948.0,474.0,228.76,1289.28,32
CDM,6341092,Simple closure of surface wound reopening,1404.0,702.0,421.2,1909.44,32
CDM,6341094,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",1037.0,518.5,311.1,1410.32,32
CDM,6341095,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",1367.0,683.5,410.1,1859.12,32
CDM,6341096,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",1680.0,840.0,479.14,2284.8,32
CDM,6341097,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",1764.0,882.0,479.14,2399.04,32
CDM,6341100,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",1008.0,504.0,302.4,1370.88,32
CDM,6341101,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",1250.0,625.0,375.0,1700.0,32
CDM,6341102,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",1276.0,638.0,382.8,1735.36,32
CDM,6341103,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",1644.0,822.0,479.14,2235.84,32
CDM,6341106,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",1185.0,592.5,355.5,1611.6,32
CDM,6341107,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",1293.0,646.5,387.9,1758.48,32
CDM,6341108,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1384.0,692.0,415.2,1882.24,32
CDM,6341109,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1437.0,718.5,431.1,1954.32,32
CDM,6341111,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",2256.0,1128.0,479.14,3068.16,32
CDM,6341122,Extensive or complicated repair of surface wound reopening,3483.0,1741.5,1044.9,4736.88,32
CDM,6341125,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",4140.0,2070.0,1242.0,5630.4,32
CDM,6341126,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",3816.0,1908.0,1144.8,5189.76,32
CDM,6341128,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",4421.0,2210.5,1326.3,6012.56,32
CDM,6341129,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",4478.0,2239.0,1343.4,6090.08,32
CDM,6341130,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",4601.0,2300.5,1380.3,6257.36,32
CDM,6341131,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",4780.0,2390.0,1434.0,6500.8,32
CDM,6341133,Creation of skin and tissue graft,2860.0,1430.0,858.0,3889.6,32
CDM,6341140,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",3434.0,1717.0,1030.2,4670.24,32
CDM,6341141,"Transfer of skin flap to eyelids, nose, ears, or lips",3266.0,1633.0,979.8,4441.76,32
CDM,6341146,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",3765.0,1882.5,1129.5,5120.4,32
CDM,6341148,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",4586.0,2293.0,1375.8,6236.96,32
CDM,6341160,"Destruction of precancer skin growth, 1 growth",485.0,242.5,145.5,659.6,32
CDM,6341161,"Destruction of precancer skin growth, 2-14 growths",355.0,177.5,106.5,482.8,32
CDM,6341162,"Destruction of precancer skin growth, 15 or more growths",1076.0,538.0,207.21,1463.36,32
CDM,6341163,"Destruction of birthmark, less than 10.0 sq cm",834.0,417.0,250.2,1427.18,32
CDM,6341166,"Destruction of skin growth, 1-14 growths",652.0,326.0,195.6,886.72,32
CDM,6341168,Application of chemical to stop tissue regrowth in wound,765.0,382.5,207.21,1040.4,32
CDM,6341169,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",575.0,287.5,172.5,782.0,32
CDM,6341170,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",716.0,358.0,207.21,973.76,32
CDM,6341171,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",768.0,384.0,207.21,1044.48,32
CDM,6341172,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",806.0,403.0,207.21,1096.16,32
CDM,6341175,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",547.0,273.5,164.1,743.92,32
CDM,6341176,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",569.0,284.5,170.7,773.84,32
CDM,6341177,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",632.0,316.0,189.6,859.52,32
CDM,6341178,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",878.0,439.0,207.21,1194.08,32
CDM,6341180,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",950.0,475.0,207.21,1292.0,32
CDM,6341182,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",761.0,380.5,207.21,1034.96,32
CDM,6341183,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",876.0,438.0,207.21,1191.36,32
CDM,6341187,Obtaining ear cartilage for grafting,10175.0,5087.5,3052.5,13838.0,32
CDM,6341188,Removal of foreskin using clamp or device,5280.0,2640.0,1584.0,7180.8,32
CDM,6341189,"INJECTION, TESTOSTERONE UNDECANOATE, 1 MG",4.0,2.0,1.2,736.42,31
CDM,6341206,Biopsy of lip,878.0,439.0,212.62,1194.08,64
CDM,6341208,Destruction of growth or scar of mouth,4377.0,2188.5,1313.1,5952.72,32
CDM,6341211,Electrical destruction of growth of anus,536.0,268.0,160.8,1913.38,32
CDM,6341213,Extensive destruction of growth of anus,4811.0,2405.5,1443.3,6542.96,32
CDM,6341216,Simple destruction of growth of penis using freezing,975.0,487.5,258.34,1326.0,32
CDM,6341218,Removal of growth of penis,3908.0,1954.0,1172.4,5314.88,32
CDM,6341219,Destruction of multiple growths of penis,3003.0,1501.5,900.9,4084.08,32
CDM,6341220,Biopsy of penis,3739.0,1869.5,1121.7,5085.04,32
CDM,6341221,Simple destruction of growth of external female genitals,4810.0,2405.0,1443.0,6541.6,32
CDM,6341222,Extensive destruction of growth of external female genitals,5051.0,2525.5,1515.3,6869.36,32
CDM,6341223,Biopsy of eyelid,2068.0,1034.0,362.6,2812.48,32
CDM,6341225,Biopsy of eyelid lining,4978.0,2489.0,1493.4,6770.08,32
CDM,6341226,Biopsy of ear,1307.0,653.5,212.62,1777.52,32
CDM,6341227,Biopsy of ear canal,4120.0,2060.0,1236.0,5603.2,32
CDM,6341231,"Creation of flap graft to nose, forehead, temple, or scalp",6296.0,3148.0,1888.8,8562.56,32
CDM,6341274,"Destruction of growth of eyelid margin, 1.0 cm or less",1693.0,846.5,362.6,2302.48,32
CDM,6341281,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1684.0,842.0,505.2,2290.24,32
CDM,6341282,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",1324.0,662.0,397.2,1800.64,32
CDM,6341283,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",1708.0,854.0,512.4,2322.88,32
CDM,6341284,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",1238.0,619.0,371.4,1683.68,32
CDM,6341285,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",749.0,374.5,224.7,1255.2,32
CDM,6342098,"Destruction of skin growth, 15 or more growths",688.0,344.0,206.4,935.68,32
CDM,6342099,"INJECTION, NATALIZUMAB, 1 MG",84.0,42.0,25.2,5897.78,31
CDM,6342100,Injection of additional drug or substance into vein provided in a facility,298.0,149.0,58.14,405.28,32
CDM,6342102,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",3988.0,1994.0,1196.4,5423.68,32
CDM,6342103,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",678.0,339.0,92.71,922.08,32
CDM,6342107,"APLIGRAF, PER SQUARE CENTIMETER",98.0,49.0,29.4,160.23,28
CDM,6342108,Instillation of anti-cancer drug into bladder,2124.0,1062.0,506.45,2888.64,32
CDM,6342109,Collection of blood sample from central venous tube,412.0,206.0,94.28,560.32,32
CDM,6342112,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",526.0,263.0,157.8,715.36,32
CDM,6342113,"Repair of wound by transferring skin, 30.1-60.0 sq cm",6296.0,3148.0,1888.8,8562.56,32
CDM,6342116,"Removal of growth under skin of face or scalp, 2.0 cm or more",3321.0,1660.5,996.3,4516.56,32
CDM,6342117,"Removal of growth of muscle of face or scalp, less than 2.0 cm",3218.0,1609.0,965.4,4376.48,32
CDM,6342118,"Removal of growth of muscle of face or scalp, 2.0 cm or more",4923.0,2461.5,1476.9,6695.28,32
CDM,6342120,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",4923.0,2461.5,1476.9,6695.28,32
CDM,6342121,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",4577.0,2288.5,1373.1,6224.72,32
CDM,6342123,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",5658.0,2829.0,1697.4,7694.88,32
CDM,6342127,"Administration of additional new drug or substance into vein, 1 hour or less",952.0,476.0,92.71,1294.72,32
CDM,6342129,"INJECTION, DENOSUMAB, 1 MG",83.0,41.5,24.9,1228.64,31
CDM,6342135,Evaluation of lower heart chamber assist device,403.0,201.5,45.43,548.08,32
CDM,6342144,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",5932.0,2966.0,951.62,8067.52,32
CDM,6342145,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",5243.0,2621.5,951.62,7130.48,32
CDM,6342146,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",2600.0,1300.0,780.0,3536.0,32
CDM,6342147,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",2427.0,1213.5,728.1,3300.72,32
CDM,6342150,Application of light to destroy precancer skin growth,563.0,281.5,168.9,765.68,32
CDM,6342151,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)",686.0,343.0,205.8,932.96,31
CDM,6342153,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",58.0,29.0,17.4,78.88,32
CDM,6342154,Rabies vaccine for injection into muscle,1149.0,574.5,141.24,1562.64,31
CDM,6342156,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",349.0,174.5,104.7,474.64,32
CDM,6342158,"EPIFIX, PER SQUARE CENTIMETER",265.0,132.5,79.5,360.4,28
CDM,6342161,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",65.0,32.5,0.5,88.4,32
CDM,6342166,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",1508.0,754.0,452.4,2050.88,32
CDM,6342172,Refilling and maintenance of portable pump,574.0,287.0,58.14,780.64,32
CDM,6342173,"INJECTION, THIAMINE HCL, 100 MG",6.0,3.0,1.8,8.16,28
CDM,6342174,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",359.0,179.5,67.66,236.94,28
CDM,6342182,"INJECTION, LANREOTIDE, 1 MG",198.0,99.0,58.39,5897.78,31
CDM,6342184,Closed treatment of broken nose bone with placement of stabilizing device,6314.0,3157.0,577.3,8587.04,32
CDM,6342186,UNCLASSIFIED DRUGS,86.0,43.0,25.8,116.96,26
CDM,6342189,Destruction of surface soft tissue of nasal passages,3744.0,1872.0,1123.2,5091.84,32
CDM,6342190,Dilation of saliva gland duct and insertion of tube,2288.0,1144.0,686.4,3111.68,32
CDM,6342192,Application of light by qualified health care professional to destroy precancer skin growth,623.0,311.5,186.9,847.28,32
CDM,6342196,Closure of permanent windpipe opening or abnormal drainage tract,5775.0,2887.5,1732.5,7854.0,32
CDM,6342197,Insertion of implant to close nasal passage,2316.0,1158.0,694.8,3149.76,32
CDM,6342201,"KERECIS OMEGA3, PER SQUARE CENTIMETER",304.0,152.0,91.2,413.44,28
CDM,6342204,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",764.0,382.0,141.24,1039.04,32
CDM,6342238,"INJECTION, CABOTEGRAVIR, 1MG, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT FOR HIV)",18.0,9.0,5.4,2382.19,31
CDM,6342239,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",77.0,38.5,23.1,4737.06,31
CDM,6342240,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",77.0,38.5,23.1,4737.06,31
CDM,6342243,"AFFINITY, PER SQUARE CENTIMETER",1705.0,852.5,160.23,2318.8,28
CDM,6352013,"HYALURONAN OR DERIVATIVE, HYALGAN, SUPARTZ OR VISCO-3, FOR INTRA-ARTICULAR INJECTION, PER DOSE",816.0,408.0,120.4,1109.76,32
CDM,6353016,Injection into tendon or ligament,960.0,480.0,288.0,1305.6,32
CDM,6353017,"Injection of trigger points, 1-2 muscles",1034.0,517.0,308.97,1406.24,32
CDM,6353018,"Injection of trigger points, 3 or more muscles",1222.0,611.0,308.97,1661.92,32
CDM,6353019,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,32
CDM,6353020,Aspiration and/or injection of fluid from medium joint,1110.0,555.0,308.97,1509.6,32
CDM,6353021,Aspiration and/or injection of fluid from small joint,916.0,458.0,274.8,1245.76,32
CDM,6353042,Aspiration and/or injection of fluid from small joint using ultrasound guidance,1169.0,584.5,350.7,1589.84,32
CDM,6353043,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,1348.0,674.0,404.4,1833.28,32
CDM,6353044,Aspiration and/or injection of fluid large joint using ultrasound guidance,1650.0,825.0,395.23,2244.0,32
CDM,6353046,Injection of carpal tunnel,966.0,483.0,289.8,1313.76,32
CDM,6353048,Destruction of peripheral nerve or branch,3421.0,1710.5,1026.3,4652.56,32
CDM,63600100,HB MED W/HCPCS RI USE ONLY,8.71,4.36,0.4,190.68,16
CDM,6360019000,"MIFEPRISTONE, ORAL, 200 MG",282.0,141.0,36.55,383.52,30
CDM,6360279000,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",552.0,276.0,121.68,750.72,32
CDM,63607296,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, (KYLEENA), 19.5 MG",4648.25,2324.13,570.27,6321.62,32
CDM,6360729600,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, (KYLEENA), 19.5 MG",3194.0,1597.0,570.27,4343.84,32
CDM,63607297,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",2397.17,1198.59,570.27,3260.15,32
CDM,63607298,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",3813.21,1906.61,570.27,5185.97,32
CDM,6360730100,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (SKYLA), 13.5 MG",2906.0,1453.0,570.27,3952.16,32
CDM,6360730700,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",1953.0,976.5,570.27,2656.08,32
CDM,63609399,UNCLASSIFIED DRUGS OR BIOLOGICALS,1104.35,552.18,0.5,1501.92,28
CDM,6360957300,"INJECTION, GADOPICLENOL, 1 ML",12.0,6.0,3.6,16.32,28
CDM,6360996300,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",2.0,1.0,0.36,2.72,28
CDM,6360996701,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.0,3.0,0.25,8.16,28
CDM,6369066100,"Influenza vaccine, trivalent, derived from cell cultures, antibiotic free, 0.5 mL dosage, for intramuscular use",85.0,42.5,25.5,115.6,32
CDM,6369067800,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",766.0,383.0,26.68,1041.76,32
CDM,6369068300,Respiratory syncytial virus vaccine mRNA lipid nanoparticles,923.0,461.5,276.9,1255.28,28
CDM,6369068400,"Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use",1091.0,545.5,322.28,1483.76,28
CDM,6369132000,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",428.0,214.0,26.68,582.08,32
CDM,6369132200,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",367.0,183.5,26.68,499.12,32
CDM,6431021,Diagnostic exam of voice box using a flexible endoscope,1086.0,543.0,212.62,1476.96,32
CDM,6431029,Diagnostic exam of nasal passages using an endoscope,1085.0,542.5,212.62,1475.6,32
CDM,6431030,REMOVAL OF IMPACTED CERUMEN (ONE OR BOTH EARS) BY PHYSICIAN ON SAME DATE OF SERVICE AS AUDIOLOGIC FUNCTION TESTING,190.0,95.0,57.0,258.4,28
CDM,6431041,Removal of cerebrospinal fluid from brain and injection of substance,1691.0,845.5,507.3,2299.76,32
CDM,6431043,Instillation of drug into kidney and/or ureter,1526.0,763.0,321.7,2075.36,32
CDM,6481025,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",138.0,69.0,41.4,2382.19,31
CDM,6481031,"INJECTION, CANAKINUMAB, 1 MG",401.0,200.5,120.3,9401.8,31
CDM,6511002,Biopsy or removal of nasal polyp or tissue using an endoscope,7700.0,3850.0,2291.78,10472.0,32
CDM,6511021,Biopsy of voice box using an endoscope,6342.0,3171.0,1902.6,8625.12,32
CDM,6511022,Biopsy of lining of nose,3284.0,1642.0,985.2,4466.24,32
CDM,6511023,Biopsy of mouth,1315.0,657.5,394.5,1788.4,32
CDM,6511024,Biopsy of front 2/3 of tongue,2443.0,1221.5,212.62,3322.48,32
CDM,6511025,Biopsy of back 1/3 of tongue,5520.0,2760.0,1656.0,7507.2,32
CDM,6511030,Simple control of nose bleed,779.0,389.5,171.32,1059.44,32
CDM,6511032,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,2229.0,1114.5,668.7,3031.44,32
CDM,6511034,HB TRACHEOSTOMY TUBES 4 CFS,218.0,109.0,54.5,143.88,16
CDM,6511040,Removal of growth of mouth with simple repair,4267.0,2133.5,1280.1,5803.12,32
CDM,6511041,Change of breathing tube in windpipe,534.0,267.0,160.2,726.24,32
CDM,6511044,Exam of the nose and throat using an endoscope,691.0,345.5,207.3,939.76,32
CDM,6511045,Removal of growth of tissue of mouth,4813.0,2406.5,1443.9,6545.68,32
CDM,6511047,Control of bleeding of nose using an endoscope,6964.0,3482.0,2089.2,9471.04,32
CDM,6511048,"Removal of skin and tissue, 20.0 sq cm or less",1980.0,990.0,479.14,2692.8,32
CDM,6511049,"Removal of muscle and/or tissue, 20.0 sq cm or less",2236.0,1118.0,479.14,3040.96,32
CDM,6511050,"Removal of bone, 20.0 sq cm or less",3859.0,1929.5,1157.7,5248.24,32
CDM,6511051,"Removal of skin and tissue, each additional 20.0 sq cm or less",1298.0,649.0,389.4,1765.28,32
CDM,6511052,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",1827.0,913.5,548.1,2484.72,32
CDM,6511055,Closed treatment of broken nose bone with manipulation,3343.0,1671.5,577.3,4546.48,32
CDM,6511056,Biopsy of soft tissue of neck or chest,3919.0,1959.5,1175.7,5329.84,32
CDM,6511058,Drainage of abscess or blood accumulation of nasal cartilage,2463.0,1231.5,694.44,3349.68,32
CDM,6511059,Removal of foreign body in nose,347.0,173.5,104.1,471.92,32
CDM,6511066,Incision of tissue connecting tongue and floor of mouth,2656.0,1328.0,796.8,3612.16,32
CDM,6511067,Removal of growth of tongue without closure,5578.0,2789.0,1673.4,7586.08,32
CDM,6511069,Removal of growth of roof of mouth,5578.0,2789.0,1673.4,7586.08,32
CDM,6511070,Drainage of abscess near tonsil,1244.0,622.0,212.62,1691.84,32
CDM,6511071,Simple drainage of abscess or blood accumulation of external ear,1574.0,787.0,212.62,2140.64,32
CDM,6511072,Complicated drainage of external ear abscess or blood accumulation,3254.0,1627.0,976.2,4425.44,32
CDM,6511074,"Removal of foreign body from tissue, accessed beneath the skin, simple",1131.0,565.5,207.21,1538.16,32
CDM,6511075,Other diagnostic procedure for gastrointestine,2955.0,1477.5,165.68,4018.8,32
CDM,6511077,Removal of growth of front 2/3 of tongue with switches,6563.0,3281.5,1755.59,8925.68,32
CDM,6511078,Other diagnostic Imaging procedure,409.0,204.5,42.12,556.24,32
CDM,6511084,Biopsy of back of throat,6226.0,3113.0,1755.59,8467.36,32
CDM,6511090,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",126.0,63.0,37.8,92.02,28
CDM,6511091,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",142.0,71.0,42.6,93.72,28
CDM,6511092,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",588.0,294.0,67.04,388.08,28
CDM,6511106,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",125.0,62.5,37.5,92.02,28
CDM,6511111,Injection of drug into side of voice box using an endoscope,4625.0,2312.5,1387.5,6290.0,32
CDM,6511115,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",124.0,62.0,37.2,1286.64,31
CDM,6521169,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",847.0,423.5,228.76,1151.92,32
CDM,6521174,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",891.0,445.5,228.76,1211.76,32
CDM,6521202,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",491.0,245.5,147.3,9401.8,32
CDM,6521204,Application of ultraviolet light to skin,304.0,152.0,38.04,413.44,32
CDM,6521205,"Acupuncture, initial 15 minutes",80.0,40.0,24.0,108.8,32
CDM,6521206,"Acupuncture, each additional 15 minutes",38.0,19.0,11.4,51.68,32
CDM,6521250,Biopsy and scraping of cervix using an endoscope,1167.0,583.5,350.1,1587.12,32
CDM,6521251,Exam of cervix and upper part of vagina using an endoscope,799.0,399.5,239.7,1086.64,32
CDM,6521252,Biopsy of cervix using an endoscope,1153.0,576.5,345.9,1568.08,32
CDM,6521253,Scraping of cervix using an endoscope,1352.0,676.0,392.37,1838.72,32
CDM,6521254,Biopsy of cervix using an endoscope with loop electrode,5749.0,2874.5,1724.7,7818.64,32
CDM,6521258,Exam and biopsy of external female genitals using an endoscope,734.0,367.0,220.2,998.24,32
CDM,6521259,Biopsy of lining of uterus,1352.0,676.0,260.32,1838.72,32
CDM,6521260,Exam of cervix using an endoscope with biopsy of lining of uterus,939.0,469.5,281.7,1277.04,32
CDM,6521261,Fitting and insertion of vaginal support device,549.0,274.5,164.7,746.64,32
CDM,6521262,Simple biopsy of vaginal mucous membrane,3438.0,1719.0,667.43,4675.68,32
CDM,6521263,"Biopsy of growth of external female genitals, first growth",2475.0,1237.5,667.43,3366.0,32
CDM,6521264,"Biopsy of growth of external female genitals, each additional growth",928.0,464.0,278.4,1262.08,32
CDM,6521265,Scraping of tissue of cervix,2376.0,1188.0,667.43,3231.36,32
CDM,6521266,Removal or destruction of cervix using loop electrode,5675.0,2837.5,1702.5,7718.0,32
CDM,6521267,Removal of IUD,901.0,450.5,265.17,1225.36,32
CDM,6521268,Insertion of IUD for pregnancy prevention,1502.0,751.0,265.17,2042.72,32
CDM,6521271,"PROBE/NEEDLE, CRYOABLATION",3863.0,1931.5,1158.9,5253.68,28
CDM,6541002,Declotting of central venous tube,1032.0,516.0,309.6,1403.52,32
CDM,6541004,Administration of prolonged chemotherapy into vein,1969.0,984.5,425.3,2677.84,32
CDM,6541014,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",187.0,93.5,55.09,254.32,32
CDM,6541015,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",124.0,62.0,15.74,168.64,32
CDM,6541020,Simple bladder irrigation and/or instillation,1033.0,516.5,108.16,1404.88,32
CDM,6541021,Simple insertion of temporary bladder tube,344.0,172.0,103.2,467.84,32
CDM,6541022,Complicated insertion of bladder tube,642.0,321.0,108.16,873.12,32
CDM,6541023,Complicated change of bladder tube,1529.0,764.5,458.7,2079.44,32
CDM,6541024,Injection of implant material beneath lining of bladder and/or urethra using an endoscope,5932.0,2966.0,1779.6,8067.52,32
CDM,6541025,Complex measurement of pressure of urine flow in bladder,863.0,431.5,258.9,1173.68,32
CDM,6541026,Complex measurement of pressure of urine flow in bladder with urethra pressure studies,1380.0,690.0,414.0,1876.8,32
CDM,6541027,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,1573.0,786.5,471.9,2139.28,32
CDM,6541028,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,2029.0,1014.5,506.45,2759.44,32
CDM,6541029,Electronic assessment of bladder emptying,646.0,323.0,193.8,878.56,32
CDM,6541030,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,635.0,317.5,165.68,863.6,32
CDM,6541031,Needle measurement and recording of electrical activity of muscles at bladder and bowel openings,1198.0,599.0,166.38,1629.28,32
CDM,6541033,Insertion of device into abdomen with pressure and urine flow rate study,783.0,391.5,108.16,1064.88,32
CDM,6541035,Repositioning of foreskin including scar tissue removal,609.0,304.5,182.7,828.24,32
CDM,6541038,Removal of sperm duct,3993.0,1996.5,1197.9,5430.48,32
CDM,6541041,Aspiration of fluid collection in testicle and sperm reservoir,2233.0,1116.5,108.16,3036.88,32
CDM,6541046,Injection of drug into erectile tissue at sides and back of penis,963.0,481.5,108.16,1309.68,32
CDM,6541047,Diagnostic exam of bladder and urethra using an endoscope,3796.0,1898.0,897.83,5162.56,32
CDM,6541048,Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope,6051.0,3025.5,1815.3,8229.36,32
CDM,6541049,Biopsy of bladder using an endoscope,6236.0,3118.0,1870.8,8480.96,32
CDM,6541050,"Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope",5932.0,2966.0,1779.6,8067.52,32
CDM,6541056,Dilation of urethra using an endoscope,5862.0,2931.0,1758.6,7972.32,32
CDM,6541067,Subsequent dilation of stricture of urethra in male by passage of dilator,377.0,188.5,108.16,512.72,32
CDM,6541070,Initial dilation of urethra in female,360.0,180.0,108.0,489.6,32
CDM,6541071,Subsequent dilation of urethra in female,283.0,141.5,84.9,384.88,32
CDM,6541088,"INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH",11.0,5.5,3.3,23.77,28
CDM,6541089,HB URINARY LEG OR ABDOMEN BAG,34.0,17.0,8.5,22.44,16
CDM,6541090,"INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMER, ETC.), EACH",10.0,5.0,2.58,6.6,28
CDM,6541095,Injection of anesthetic agent and/or steroid into other nerve or branch,1931.0,965.5,500.68,2626.16,32
CDM,6541098,"CATHETER, SUPRAPUBIC/CYSTOSCOPIC",388.0,194.0,116.4,527.68,28
CDM,6541101,Simple drainage of cyst of tailbone,1332.0,666.0,207.21,1811.52,32
CDM,6541102,Needle biopsy of breast,3254.0,1627.0,976.2,4425.44,32
CDM,6541103,"Removal of growth and tissue of breast, duct, or nipple",6587.0,3293.5,1669.7,8958.32,32
CDM,6541105,Laser destruction of incompetent vein of arm or leg using imaging guidance,5360.0,2680.0,1608.0,7289.6,32
CDM,6541110,Drainage of superficial rectal abscess surrounding anus,3265.0,1632.5,979.5,4440.4,32
CDM,6541111,Incision of external hemorrhoid with blood clot,699.0,349.5,209.7,1913.38,32
CDM,6541112,Simple removal of growth of anus,4764.0,2382.0,1429.2,6479.04,32
CDM,6541114,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",499.0,249.5,141.24,678.64,32
CDM,6541118,Complicated drainage of cyst of tailbone,1950.0,975.0,585.0,2652.0,32
CDM,6541120,Exam with injections of chemical for destruction of bladder using an endoscope,6618.0,3309.0,1954.24,9000.48,32
CDM,6541124,Placement of device in prostate for radiation therapy,4923.0,2461.5,1335.85,6695.28,32
CDM,6541127,"Removal of growth under skin of leg or ankle, 3.0 cm or more",8950.0,4475.0,2685.0,12172.0,32
CDM,6541134,Insertion of lower leg neurostimulator electrode,869.0,434.5,260.7,1181.84,32
CDM,6541144,Complicated removal of foreign body in deep muscle or tendon,7249.0,3624.5,2174.7,9858.64,32
CDM,6541145,Removal of surface implant from bone,5500.0,2750.0,1650.0,7480.0,32
CDM,6541154,"PESSARY, REUSABLE, RUBBER, ANY TYPE",127.0,63.5,29.21,83.82,28
CDM,6541156,"Osteopathic manipulative treatment, 5-6 body regions",89.0,44.5,26.7,121.04,32
CDM,6541158,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",1114.0,557.0,334.2,1515.04,32
CDM,6541159,Shingles vaccine for injection into muscle,606.0,303.0,141.24,824.16,30
CDM,6541160,"Fine needle aspiration biopsy, each additional growth",600.0,300.0,180.0,908.49,30
CDM,6541161,"Fine needle aspiration biopsy using ultrasound guidance, first growth",3326.0,1663.0,857.07,4523.36,30
CDM,6541162,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",1307.0,653.5,392.1,1777.52,30
CDM,6541163,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",1465.0,732.5,439.5,1992.4,30
CDM,6541164,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",650.0,325.0,195.0,908.49,30
CDM,6541165,"Fine needle aspiration biopsy of growth using CT guidance, first growth",2063.0,1031.5,618.9,2805.68,30
CDM,6541166,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",750.0,375.0,225.0,1020.0,30
CDM,6541169,"Biopsy of related skin growth, first growth",1023.0,511.5,306.9,1391.28,32
CDM,6541170,"Punch biopsy, first skin growth",1024.0,512.0,307.2,1392.64,32
CDM,6541171,"Incision biopsy, first skin growth",1579.0,789.5,473.7,2147.44,32
CDM,6541172,"Biopsy of related skin growth, each additional growth",713.0,356.5,213.9,969.68,32
CDM,6541173,"Punch biopsy, each additional skin growth",648.0,324.0,194.4,881.28,32
CDM,6541174,"Incision biopsy, each additional skin growth",550.0,275.0,165.0,748.0,32
CDM,6541175,Replacement of stomach stoma tube,1184.0,592.0,321.7,1610.24,32
CDM,6541176,Replacement of stomach stoma tube with revision of stoma opening,1088.0,544.0,321.7,1479.68,32
CDM,6541180,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,405.0,202.5,48.05,550.8,32
CDM,6541181,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,625.0,312.5,122.41,850.0,32
CDM,6541182,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",649.0,324.5,122.41,882.64,32
CDM,6541183,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",448.0,224.0,134.4,609.28,32
CDM,6541192,Injection of biodegradable material next to prostate,10771.0,5385.5,3231.3,14648.56,32
CDM,6541193,Injection of anesthetic agent and/or steroid into vagus nerve,1227.0,613.5,368.1,1668.72,32
CDM,6541194,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",237.0,118.5,71.1,322.32,28
CDM,6541195,"Influenza vaccine, inactivated",223.0,111.5,26.68,303.28,32
CDM,6541197,"Removal of growth under skin of back or lower sides, less than 3.0 cm",4574.0,2287.0,1372.2,6220.64,32
CDM,6541198,Diagnostic exam of voice box using an endoscope with mirror,685.0,342.5,205.5,931.6,32
CDM,6541199,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",7821.0,3910.5,2246.0,10636.56,32
CDM,6541200,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",7920.0,3960.0,2246.0,10771.2,32
CDM,6541201,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",9594.0,4797.0,2246.0,13047.84,32
CDM,6541202,Insertion of sacral nerve neurostimulator electrode array,19250.0,9625.0,5775.0,26180.0,32
CDM,6541206,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",5547.0,2773.5,1664.1,7543.92,32
CDM,6541209,"Removal of growth under skin of thigh or knee, less than 3.0 cm",8148.0,4074.0,2246.0,11081.28,32
CDM,6601001,Aspiration of bone marrow sample for diagnosis,2533.0,1266.5,759.9,3444.88,32
CDM,6601002,Biopsy of bone marrow,2609.0,1304.5,782.7,3548.24,32
CDM,6601009,Biopsy and aspiration of bone marrow sample for diagnosis,4589.0,2294.5,1376.7,6241.04,32
CDM,6729700,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",2011.0,1005.5,570.27,2734.96,32
CDM,6730000,INTRAUTERINE COPPER CONTRACEPTIVE (PARAGARD),3809.0,1904.5,121.68,5180.24,32
CDM,7001003,Photography of content of eyes,370.0,185.0,48.09,503.2,32
CDM,7001006,Exam of retinal blood vessels using a special camera after injection of a dye,1005.0,502.5,278.02,1366.8,32
CDM,7001008,Incision and drainage of abscess of eyelid,1241.0,620.5,362.6,1687.76,32
CDM,7001009,Photography of the retina,578.0,289.0,70.21,786.08,32
CDM,7001010,Imaging of front third of eye using a special microscope,620.0,310.0,70.21,843.2,32
CDM,7001011,1D ultrasound scan of eye tissue and structures,626.0,313.0,78.49,851.36,32
CDM,7001035,Destruction of leaking blood vessels of retina using laser,4220.0,2110.0,708.17,5739.2,32
CDM,7001036,Destruction of growth of retina using a laser,3438.0,1719.0,708.17,4675.68,32
CDM,7001037,Photocoagulation treatment to prevent detachment of retina,3277.0,1638.5,708.17,4456.72,32
CDM,7001039,Laser repair to improve eye fluid flow,2438.0,1219.0,708.17,3315.68,32
CDM,7001040,"Creation of eye fluid drainage tracts in iris using a laser, per session",1746.0,873.0,523.8,2374.56,32
CDM,7001041,Removal of recurring cataract in lens capsule using a laser,3381.0,1690.5,708.17,4598.16,32
CDM,7001042,Release of scar tissue between lens and retina using a laser,1763.0,881.5,528.9,2397.68,32
CDM,7001067,Ultrasound scan to determine eye length and lens power,464.0,232.0,78.49,631.04,32
CDM,7001070,2D ultrasound scan of eye tissue and structures,576.0,288.0,73.38,783.36,32
CDM,7001073,Ultrasound scan of eye using water bath method,727.0,363.5,95.32,988.72,32
CDM,7001081,Removal of growth of cornea,5454.0,2727.0,714.21,7417.44,32
CDM,7001088,Removal of eye fluid,6381.0,3190.5,1264.82,8678.16,32
CDM,7001092,Injection of air or liquid into eye,6188.0,3094.0,1264.82,8415.68,32
CDM,7001098,Repair of detached retina by injection of air or gas,4714.0,2357.0,1287.45,6411.04,32
CDM,7001112,Removal of chronic growth of eyelid,2516.0,1258.0,362.6,3421.76,32
CDM,7001114,Removal of multiple chronic growths of same eyelid,2906.0,1453.0,871.8,3952.16,32
CDM,7001116,Removal of multiple chronic growths of different eyelids,3051.0,1525.5,362.6,4149.36,32
CDM,7001127,Removal of growth of eyelid,3563.0,1781.5,1068.9,4845.68,32
CDM,7001129,Creation of permanent eyelid margin scarring,6519.0,3259.5,1659.96,8865.84,32
CDM,7001131,Removal of embedded foreign body in eyelid,1104.0,552.0,331.2,1501.44,32
CDM,7001135,"Removal of growth of eyelid lining, 1.0 cm or less",5269.0,2634.5,1264.82,7165.84,32
CDM,7001143,Biopsy of tear producing gland,5262.0,2631.0,1578.6,7156.32,32
CDM,7001148,Closure of tear duct opening using plug,1026.0,513.0,307.8,1395.36,32
CDM,7001154,Repair of lacerated cornea and/or sclera using tissue glue,4697.0,2348.5,714.21,6387.92,32
CDM,7001157,Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye,777.0,388.5,233.1,1056.72,32
CDM,7001164,Injection of drug into eye,1351.0,675.5,362.6,1837.36,32
CDM,7001168,CT scan of cornea,281.0,140.5,70.21,382.16,32
CDM,7001177,Destruction of lens tissue using laser,5262.0,2631.0,1264.82,7156.32,32
CDM,7001178,Incision of cornea to correct astigmatism,2162.0,1081.0,648.6,2940.32,32
CDM,7001179,Tying or biopsy of artery on side of skull,6144.0,3072.0,1843.2,8355.84,32
CDM,7001180,Incision of corner of eye at eyelid,5262.0,2631.0,1578.6,7156.32,32
CDM,7001182,Exploration of cavity behind eye,8201.0,4100.5,2460.3,11153.36,32
CDM,7001187,Removal of foreign body in cornea using slit lamp,588.0,294.0,94.55,799.68,32
CDM,7001188,Biopsy of tear sac,3648.0,1824.0,1094.4,4961.28,32
CDM,7001191,Probing of nasal tear duct,1500.0,750.0,362.6,2040.0,32
CDM,7001204,Plastic repair of tear duct,3648.0,1824.0,1094.4,4961.28,32
CDM,7001205,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,979.0,489.5,278.02,1331.44,32
CDM,7062008,Removal of eggs from ovaries,4500.0,2250.0,512.67,6120.0,32
CDM,7062009,"Culture of eggs or embryos, less than 4 days",2331.0,1165.5,122.22,3170.16,32
CDM,7062010,Injection of fertilized eggs into uterus,1813.0,906.5,512.67,2465.68,32
CDM,7062011,Assisted embryo hatching (fertility procedure),1301.0,650.5,122.22,1769.36,32
CDM,7062016,Diagnostic exam of abdomen using an endoscope,10035.0,5017.5,3010.5,13647.6,32
CDM,7062022,Preparation of embryo for transfer,371.0,185.5,67.1,504.56,32
CDM,7062023,Egg identification from ovarian fluid,1090.0,545.0,122.22,1482.4,32
CDM,7062026,Frozen preservation of embryos,1277.0,638.5,122.22,2795.44,32
CDM,7062027,Frozen preservation of sperm,567.0,283.5,122.22,771.12,32
CDM,7062028,Sperm isolation with semen analysis for fertilization or diagnosis,349.0,174.5,67.1,474.64,32
CDM,7062029,Sperm isolation and semen analysis for fertilization or diagnosis,451.0,225.5,67.1,613.36,32
CDM,7062032,Semen analysis motility and count,278.0,139.0,5.05,378.08,32
CDM,7062041,Ultrasonic guidance for retrieval of egg,1200.0,600.0,95.32,1632.0,32
CDM,7062042,Sperm identification from testis tissue,1026.0,513.0,67.1,1395.36,32
CDM,7062046,"Extended culture of eggs or embryos, 4-7 days",2010.0,1005.0,122.22,2795.44,32
CDM,7062047,"Assisted oocyte fertilization (fertility procedure), less than or equal to 10 oocytes",3582.0,1791.0,122.22,4871.52,32
CDM,7062048,"Assisted oocyte fertilization (fertility procedure), greater than 10 oocytes",3917.0,1958.5,122.22,5327.12,32
CDM,7062049,Frozen preservation of male reproductive tissue,679.0,339.5,67.1,923.44,32
CDM,7062051,Pathology tests,816.0,408.0,33.44,1109.76,32
CDM,7062052,Thawing of frozen embryos,686.0,343.0,122.22,932.96,32
CDM,7062053,Thawing of frozen sperm or semen,182.0,91.0,58.24,247.52,32
CDM,7062055,Thawing of frozen eggs,816.0,408.0,122.22,1109.76,32
CDM,7062057,Storage of sperm or semen per year,268.0,134.0,85.76,566.1,32
CDM,7062059,"Storage of eggs, per year",268.0,134.0,85.76,1166.8,32
CDM,7062060,Semen analysis for sperm presence,255.0,127.5,5.05,346.8,32
CDM,7062062,Reproductive medicine laboratory procedure,186.0,93.0,33.44,252.96,32
CDM,7062065,HB STORAGE EMBRYO PER 3 MONTHS,165.0,82.5,41.25,108.9,16
CDM,7062066,HB STORAGE SPERM PER 3 MONTHS,425.0,212.5,106.25,280.5,16
CDM,7062068,"Storage of eggs, per year",268.0,134.0,85.76,1166.8,32
CDM,7062069,"Biopsy of egg or embryo for pre-implantation genetic diagnosis, less than or equal to 5 embryos",1530.0,765.0,122.22,2080.8,32
CDM,7062070,"Biopsy of egg or embryo for pre-implantation genetic diagnosis, greater than 5 embryos",1935.0,967.5,122.22,2631.6,32
CDM,7062073,HB PACKAGE 3 D5/D6 CULTURE. NO ET. CRYO ALL,8030.0,4015.0,2409.0,4818.0,2
CDM,7062075,HB PACKAGE 5 THAW AND ET,2200.0,1100.0,660.0,1320.0,2
CDM,7062076,HB PACKAGE 6 FERTILITY PRESERVATION CRYO OF OOCYTES + STORAGE,4620.0,2310.0,1386.0,2772.0,2
CDM,7091018,Special radiation treatment,4044.0,2022.0,89.58,5499.84,32
CDM,7091124,Insertion of device into vagina for radiation therapy,1581.0,790.5,392.37,2150.16,32
CDM,7121038,Insertion of needle or tube into prostate for radiation therapy,8938.0,4469.0,2681.4,12155.68,32
CDM,7181050,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,5397.0,2698.5,1349.25,3562.02,16
CDM,7181052,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,7361.0,3680.5,1840.25,4858.26,16
CDM,7181054,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,7852.0,3926.0,1963.0,5182.32,16
CDM,7181056,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,7976.0,3988.0,1994.0,5264.16,16
CDM,7181057,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,128.0,64.0,32.0,84.48,16
CDM,7181058,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,8141.0,4070.5,2035.25,5373.06,16
CDM,7181061,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,7110.0,3555.0,1777.5,4692.6,16
CDM,7181062,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,138.0,69.0,34.5,91.08,16
CDM,7181063,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,5233.0,2616.5,1308.25,3453.78,16
CDM,7181064,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,45.0,22.5,11.25,29.7,16
CDM,7181065,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,6541.0,3270.5,1635.25,4317.06,16
CDM,7181066,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,54.0,27.0,13.5,35.64,16
CDM,7181067,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,8111.0,4055.5,2027.75,5353.26,16
CDM,7181068,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,65.0,32.5,16.25,42.9,16
CDM,7181069,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,10465.0,5232.5,2616.25,6906.9,16
CDM,7181070,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,78.0,39.0,19.5,51.48,16
CDM,7181071,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,14652.0,7326.0,3663.0,9670.32,16
CDM,7181072,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,93.0,46.5,23.25,61.38,16
CDM,7181073,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,12559.0,6279.5,3139.75,8288.94,16
CDM,7181074,OPERATING ROOM SERVICES - GENERAL CLASSIFICATION,86.0,43.0,21.5,56.76,16
CDM,7185561,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",107.25,53.63,32.18,239.91,28
CDM,7186001,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,1450.0,725.0,122.41,1972.0,32
CDM,7187001,HB GENERAL MED/SURG SUPPLY,11.1,5.55,1.51,36.15,16
CDM,7187002,HB STERILE SUPPLY,386.02,193.01,48.97,833.88,16
CDM,7187010,"CATHETER, DRAINAGE",126.12,63.06,23.57,242.89,28
CDM,7187012,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",374.7,187.35,42.64,819.83,28
CDM,7187015,"CATHETER, THROMBECTOMY/EMBOLECTOMY",354.605,177.3,104.53,444.25,28
CDM,7187016,"CATHETER, URETERAL",63.475,31.740000000000002,16.47,98.0,28
CDM,7187020,GUIDE WIRE,401.7,200.85000000000002,72.95,2368.22,28
CDM,7187028,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",10043.16,5021.58,1104.75,13658.7,28
CDM,7187032,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",463.09,231.54,63.29,1609.62,28
CDM,7187033,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",576.45,288.23,172.94,783.97,28
CDM,7187034,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",154.18,77.095,45.89,331.77,28
CDM,7187037,"CATHETER, SUPRAPUBIC/CYSTOSCOPIC",79.38,39.69,23.82,107.96,28
CDM,7187048,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",830.87,415.44,232.29,1721.42,28
CDM,7187053,JOINT DEVICE (IMPLANTABLE),1866.0,933.0,559.8,2537.76,28
CDM,7187054,"CATHETER, BALLOON DILATATION, NON-VASCULAR",1707.61,853.8,512.28,2322.35,28
CDM,7187090,"APLIGRAF, PER SQUARE CENTIMETER",98.0,49.0,29.4,160.23,28
CDM,7187129,HB GASTROSTOMY/JEJUNOSTOMY TUBE L-P,674.9300000000001,337.46500000000003,152.73,487.71,16
CDM,7187130,HB GASTROSTOMY/JEJUNOSTOM TUBE STANDARD,915.93,457.96,79.32,603.23,16
CDM,7187133,"CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO-PIECE, PREFABRICATED, OFF-THE-SHELF",158.22,79.11,47.47,236.71,28
CDM,7187134,SLINGS,13.87,6.94,4.16,14.93,28
CDM,7187135,HB NEG PRESS WND THRPY DRESSING SET,1353.65,676.82,338.41,893.41,16
CDM,7187177,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1174.0,587.0,352.2,1596.64,28
CDM,7187182,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",73.13,36.57,21.94,111.52,28
CDM,7187247,Closed treatment of dislocated shoulder with manipulation under anesthesia,5243.0,2621.5,1211.37,7130.48,32
CDM,7187292,"EPICORD, PER SQUARE CENTIMETER",1037.0,518.5,160.23,1410.32,28
CDM,7242069,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",11.0,5.5,1.22,14.96,28
CDM,7242071,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",9527.0,4763.5,1954.24,12956.72,32
CDM,7242072,"Complicated removal of foreign body, stone, or stent in urethra or bladder using an endoscope",11003.0,5501.5,1954.24,14964.08,32
CDM,7271000,RECOVERY ROOM - GENERAL CLASSIFICATION,1772.0,886.0,443.0,1169.52,16
CDM,7271008,Therapy using electrical currents,1576.0,788.0,472.8,2143.36,30
CDM,7271010,RECOVERY ROOM - GENERAL CLASSIFICATION,556.0,278.0,139.0,366.96,16
CDM,7271011,Manipulation of knee joint under anesthesia,3663.0,1831.5,1098.9,4981.68,32
CDM,7271016,OPERATING ROOM SERVICES - MINOR SURGERY,861.0,430.5,215.25,568.26,16
CDM,7271017,OPERATING ROOM SERVICES - MINOR SURGERY,372.0,186.0,93.0,245.52,16
CDM,7301008,"FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES",542.0,271.0,162.6,737.12,28
CDM,7301020,Nuclear medicine study of brain with metabolic evaluation,6318.0,3159.0,220.91,8592.48,32
CDM,7301075,Nuclear medicine study from skull base to mid-thigh with CT scan,8389.0,4194.5,1575.0,11409.04,32
CDM,7301076,Nuclear medicine study limited area with CT scan,6542.0,3271.0,1575.0,8897.12,32
CDM,7301077,Nuclear medicine study whole body with CT scan,9500.0,4750.0,1575.0,12920.0,32
CDM,7301079,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",219.0,109.5,65.7,297.84,27
CDM,7301081,"FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURIE",1352.0,676.0,405.6,1838.72,27
CDM,7301083,"PIFLUFOLASTAT F 18 (PYLARIFY), DIAGNOSTIC, 1 MILLICURIE",1845.0,922.5,553.5,2509.2,27
CDM,7301084,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MILLICURIE",2053.0,1026.5,615.9,2792.08,27
CDM,7309300500,Routine electrocardiogram (ECG) using at least 12 leads with tracing,453.0,226.5,32.27,616.08,32
CDM,7311001,"Insertion of tube into chest or arm artery, each first order branch",2091.0,1045.5,627.3,2843.76,32
CDM,7311003,"Insertion of tube into chest or arm artery, initial third order branch",3562.0,1781.0,858.24,4844.32,32
CDM,7311004,"Insertion of tube into chest or arm artery, additional second, third order and beyond",1513.0,756.5,453.9,2057.68,32
CDM,7311005,Occlusion of central nervous system or spinal cord artery,20930.0,10465.0,6279.0,28464.8,32
CDM,7311008,Occlusion of head or neck artery,28259.0,14129.5,8477.7,38432.24,32
CDM,7311020,Review by radiologist of spinal artery image,8453.0,4226.5,237.72,11496.08,32
CDM,7311024,Review by radiologist of head or neck vein system image,4922.0,2461.0,160.44,6693.92,32
CDM,7311025,Review by radiologist of head vein system image,4922.0,2461.0,166.29,6693.92,32
CDM,7311028,Review by radiologist of imaging guidance for removal of blood sample,8453.0,4226.5,168.23,11496.08,32
CDM,7311029,Review by radiologist of image for insertion of material to block blood flow,5605.0,2802.5,253.72,7622.8,32
CDM,7311032,Imaging of blood vessel,4922.0,2461.0,66.16,6693.92,32
CDM,7311035,Measurement of brain wave activity (EEG) in specific area of brain,2122.0,1061.0,415.87,2885.92,32
CDM,7311042,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",3199.0,1599.5,858.24,4350.64,32
CDM,7311044,Review by radiologist of pelvis artery image,8453.0,4226.5,194.18,11496.08,32
CDM,7311046,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",3541.0,1770.5,858.24,4815.76,32
CDM,7311047,Insertion of stent and blood clot protection device in neck artery with review by radiologist,7737.0,3868.5,2321.1,18704.53,32
CDM,7311048,Insertion of stent in neck artery with review by radiologist,16772.0,8386.0,5031.6,22809.92,32
CDM,7311051,Balloon occlusion of head or neck artery with review by radiologist,19289.0,9644.5,5786.7,26233.04,32
CDM,7311057,Insertion of tube into aorta,2063.0,1031.5,618.9,2805.68,32
CDM,7311060,Insertion of stent in blood vessel of head,5828.0,2914.0,1748.4,18704.53,32
CDM,7311066,Fluoroscopic guidance for needle placement,1361.0,680.5,81.86,1850.96,32
CDM,7311067,Fluoroscopic guidance for spine or back muscle injection,967.0,483.5,83.59,1315.12,32
CDM,7311068,3D radiographic procedure,608.0,304.0,182.4,826.88,28
CDM,7311069,Balloon dilation of blood vessel in head,4713.0,2356.5,1413.9,18704.53,32
CDM,7311072,3D radiographic procedure with computerized image postprocessing,651.0,325.5,195.3,885.36,28
CDM,7311080,CT scan of blood vessels of head with contrast,3047.0,1523.5,225.85,4143.92,32
CDM,7311087,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",5264.0,2632.0,1579.2,7159.04,32
CDM,7311091,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,10479.0,5239.5,3143.7,14251.44,32
CDM,7311092,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,20958.0,10479.0,4065.55,28502.88,32
CDM,7311094,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,10383.0,5191.5,3114.9,14120.88,32
CDM,7311095,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,15575.0,7787.5,4672.5,21182.0,32
CDM,7311097,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,20106.0,10053.0,5547.53,27344.16,32
CDM,7311098,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,30159.0,15079.5,5547.53,41016.24,32
CDM,7311100,Insertion of tube into chest artery for diagnosis or treatment with review by radiologist,11064.0,5532.0,3319.2,15047.04,32
CDM,7311103,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,15129.0,7564.5,4538.7,20575.44,32
CDM,7311104,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,22694.0,11347.0,5547.53,30863.84,32
CDM,7311105,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,15129.0,7564.5,4538.7,20575.44,32
CDM,7311106,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,16936.0,8468.0,5080.8,23032.96,32
CDM,7311107,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,25404.0,12702.0,5547.53,34549.44,32
CDM,7311109,Insertion of tube into neck or brain artery for diagnosis or treatment with review by radiologist,6625.0,3312.5,1987.5,9010.0,32
CDM,7311115,Occlusion of artery with review by radiologist,28078.0,14039.0,8423.4,38186.08,32
CDM,7311116,Occlusion of growths or obstructed vessels with review by radiologist,22844.0,11422.0,6853.2,31067.84,32
CDM,7311119,"Insertion of stent in vein with review by radiologist, initial vein",18833.0,9416.5,5649.9,25612.88,32
CDM,7311122,"Insertion of tube into vein, second order branch",2750.0,1375.0,825.0,3740.0,32
CDM,7313317,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",4355.0,2177.5,858.24,5922.8,32
CDM,7313443,Other procedure on nervous system,4405.0,2202.5,395.23,5990.8,32
CDM,7313500,Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance,10297.0,5148.5,3089.1,18704.53,32
CDM,7313501,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",17732.0,8866.0,4624.13,24115.52,32
CDM,7313502,"Balloon dilation of artery with review by radiologist, initial artery",10467.0,5233.5,3140.1,14235.12,32
CDM,7313506,"Insertion of tube into vein, first order branch",2265.0,1132.5,679.5,3080.4,32
CDM,7321000,HB ANESTHESIA 1ST HOUR,3990.0,1995.0,997.5,2633.4,16
CDM,7321030,HB ANESTHESIA EACH ADDL MINUTE,22.0,11.0,5.5,14.52,16
CDM,7322000,HB OB ANESTHESIA GENERAL 1ST HR,2000.0,1000.0,500.0,1320.0,16
CDM,7322002,HB OB ANESTHESIA GENERAL EA ADD 30 MINS,350.0,175.0,87.5,231.0,16
CDM,7322003,Injection of blood or blood clot into spinal canal,2063.0,1031.5,618.9,2805.68,32
CDM,7322005,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,7322006,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,7322010,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,7322012,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,7322013,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,7322015,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,7322016,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,7322018,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,32
CDM,7322019,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,32
CDM,7324005,Placement of skin electrodes and measurement of stimulated sites in arms,1174.0,587.0,66.16,1596.64,32
CDM,7324009,Measurement of brain wave activity (EEG) outside the brain during surgery,1464.0,732.0,415.87,1991.04,32
CDM,7324010,"Measurement of brain wave activity (EEG), 61-119 minutes",2960.0,1480.0,278.02,4025.6,32
CDM,7324013,Needle measurement of electrical activity in muscles on side of body,715.0,357.5,166.38,972.4,32
CDM,7324015,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",1591.0,795.5,415.87,2163.76,32
CDM,7324016,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, each additional hour",501.0,250.5,150.3,681.36,32
CDM,7324017,Placement of skin electrodes and measurement of central motor stimulation in arms,1591.0,795.5,166.38,2163.76,32
CDM,7324018,Placement of skin electrodes and measurement of central motor stimulation in legs,1105.0,552.5,166.38,1502.8,32
CDM,7324019,"Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study",319.0,159.5,95.7,433.84,32
CDM,7324020,"Measurement of brain wave activity (EEG), 41-60 minutes",1892.0,946.0,128.96,2573.12,32
CDM,7324034,Placement of skin electrodes and measurement of central motor stimulation in arms and legs,2389.0,1194.5,166.38,3249.04,32
CDM,7324035,Placement of skin electrodes and measurement of stimulated sites on arms and legs,1216.0,608.0,166.38,1653.76,32
CDM,7324036,"Continuous monitoring of nervous system during operation, each 15 minutes",288.0,144.0,86.4,391.68,28
CDM,7324037,"Continuous monitoring of nervous system during operation, each 15 minutes",288.0,144.0,86.4,391.68,28
CDM,7324039,HB IONM ELECTRODE SET FOR :  ABR,33.0,16.5,8.25,21.78,16
CDM,7324040,HB IONM ELECTRODE SET FOR :  SSEP-UE,51.0,25.5,12.75,33.66,16
CDM,7324041,HB IONM ELECTRODE SET FOR :  SSEP-LE,61.0,30.5,15.25,40.26,16
CDM,7324042,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",91.0,45.5,27.3,123.76,28
CDM,7324043,HB IONM ELECTRODE SET FOR :  CRAINIAL-N,55.0,27.5,13.75,36.3,16
CDM,7324044,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",74.0,37.0,22.2,100.64,28
CDM,7324045,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",70.0,35.0,21.0,95.2,28
CDM,7324046,HB IONM ELECTRODE SET FOR :  EEG,24.0,12.0,6.0,15.84,16
CDM,7371005,SLINGS,16.0,8.0,4.8,14.93,28
CDM,7371012,"SURGICAL BOOT/SHOE, EACH",22.0,11.0,6.6,29.92,28
CDM,7371043,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",51.0,25.5,15.3,239.91,28
CDM,7371067,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE, PREFABRICATED, OFF-THE-SHELF (FOAM COLLAR)",17.0,8.5,5.1,44.21,28
CDM,7381004,HB ORGAN ACQUISITION KIDNEY CADAVER,176100.0,88050.0,44025.0,116226.0,14
CDM,7401003,HB ORGAN ACQUISITION KIDNEY LIVE DONOR,142600.0,71300.0,35650.0,94116.0,14
CDM,7401004,HB NMDP OPEN CODE,26947.25,13473.63,6736.81,17785.19,14
CDM,7436000,Review by radiologist of image to guide opening of digestive tract,810.0,405.0,196.23,1101.6,32
CDM,7451001,HB ORGAN ACQUISITION LIVER CADAVER,223000.0,111500.0,55750.0,147180.0,14
CDM,7500978500,"ENDOSCOPIC OUTLET REDUCTION, GASTRIC POUCH APPLICATION, WITH ENDOSCOPY AND INTRALUMINAL TUBE INSERTION, IF PERFORMED, INCLUDING ALL SYSTEM AND TISSUE ANCHORING COMPONENTS",30523.0,15261.5,4447.47,41511.28,32
CDM,7500990100,"ENDOSCOPIC DEFECT CLOSURE WITHIN THE ENTIRE GASTROINTESTINAL TRACT, INCLUDING UPPER ENDOSCOPY (INCLUDING DIAGNOSTIC, IF PERFORMED) OR COLONOSCOPY (INCLUDING DIAGNOSTIC, IF PERFORMED), WITH ALL SYSTEM ",16280.0,8140.0,4884.0,22140.8,28
CDM,7504375300,Insertion of stomach tube and aspiration of stomach contents,688.0,344.0,206.4,935.68,28
CDM,7504437000,Insertion of small bowel stent above lower small bowel using an endoscope,18616.0,9308.0,2516.76,25317.76,32
CDM,7504437800,Control of bleeding of small bowel using an endoscope,8541.0,4270.5,2470.77,11615.76,32
CDM,7504623000,Removal of multiple external noncancer growths of anus,9350.0,4675.0,1805.07,12716.0,32
CDM,7504660000,Diagnostic exam of anus using an endoscope,1112.0,556.0,171.32,1512.32,32
CDM,7511001,HB ORGAN ACQUISITION PANCREAS,129300.0,64650.0,32325.0,85338.0,14
CDM,7601001,Test to assess middle ear function,280.0,140.0,38.31,380.8,32
CDM,7601002,Test for hearing various pitches using earphone and device placed against the bone,419.0,209.5,100.23,569.84,32
CDM,7601003,Comprehensive hearing and speech recognition test,508.0,254.0,100.23,690.88,32
CDM,7601012,Evaluation of swallowing function,638.0,319.0,71.1,867.68,32
CDM,7601020,Test to assess electrical potentials generated in the inner ear as a result of sound stimulation,897.0,448.5,100.23,1219.92,32
CDM,7601025,Evaluation of swallowing function image,684.0,342.0,91.91,930.24,32
CDM,7601031,Test for screening hearing,167.0,83.5,38.31,227.12,32
CDM,7601035,Exam to assess movement of vocal cord flaps using an endoscope,2446.0,1223.0,503.61,3326.56,32
CDM,7601037,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,886.0,443.0,100.23,1204.96,32
CDM,7601038,Placement of ear probe for computerized measurement of sound with interpretation and report,650.0,325.0,100.23,884.0,32
CDM,7601125,Test for hearing various pitches using earphone,259.0,129.5,38.31,352.24,32
CDM,7601126,Test for ability to detect and repeat spoken words,207.0,103.5,38.31,281.52,32
CDM,7601127,Test to assess middle ear muscle reflex,174.0,87.0,38.31,236.64,32
CDM,7601131,Test for abnormal eye movement with recording,345.0,172.5,38.31,469.2,32
CDM,7601139,Test for abnormal eye movement using a moving target that moves back and forth with recording,629.0,314.5,38.31,855.44,32
CDM,7601144,Test for abnormal eye movement using a moving target with recording,506.0,253.0,38.31,688.16,32
CDM,7601149,Evaluation for use of voice artificial device to supplement oral speech,638.0,319.0,73.43,867.68,32
CDM,7601150,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",514.0,257.0,47.09,699.04,32
CDM,7601162,Analysis and programming of inner ear implant (younger than 7 years),506.0,253.0,45.43,688.16,32
CDM,7601163,Analysis and reprogramming of inner ear implant (younger than 7 years),482.0,241.0,45.43,655.52,32
CDM,7601164,Analysis and programming of inner ear implant (7 years or older),561.0,280.5,45.43,762.96,32
CDM,7601165,Analysis and reprogramming of inner ear implant (7 years or older),493.0,246.5,45.43,670.48,32
CDM,7601173,"Treatment of speech, language, voice, communication, and/or hearing processing disorder in a group setting",368.0,184.0,24.31,500.48,32
CDM,7601176,Treatment of swallowing and feeding disorder,544.0,272.0,45.25,739.84,32
CDM,7601177,Test to assess hearing sensitivity using visual aids,443.0,221.5,100.23,602.48,32
CDM,7601185,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",590.0,295.0,134.48,389.4,28
CDM,7601186,TRACHEOSTOMY SPEAKING VALVE,374.0,187.0,112.2,246.84,28
CDM,7601187,Evaluation and recording of swallowing using an endoscope,775.0,387.5,66.47,1054.0,32
CDM,7601191,"Evaluation of hearing function related to surgically implanted hearing device, first hour",575.0,287.5,165.68,782.0,32
CDM,7601192,"Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes",221.0,110.5,66.3,303.05,32
CDM,7601193,Test to assess hearing sensitivity using activity related feedback,491.0,245.5,100.23,667.76,32
CDM,7601194,Test to assess hearing loss,178.0,89.0,38.31,242.08,32
CDM,7601198,Evaluation and testing for balance with recording,1250.0,625.0,172.78,1700.0,32
CDM,7601199,Comprehensive hearing test,552.0,276.0,100.23,750.72,32
CDM,7601200,Test for eardrum and muscle function,437.0,218.5,100.23,594.32,32
CDM,7601203,Test for screening hearing using a probe,753.0,376.5,38.31,1024.08,32
CDM,7601235,Test to assess hearing using pictures,207.0,103.5,38.31,281.52,32
CDM,7601238,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",1125.0,562.5,134.48,742.5,28
CDM,7601239,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",971.0,485.5,134.48,640.86,28
CDM,7601240,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",748.0,374.0,134.48,493.68,28
CDM,7601243,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",203.0,101.5,60.9,133.98,28
CDM,7601249,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",733.0,366.5,134.48,483.78,28
CDM,7601250,"INSERT FOR INDWELLING TRACHEOESOPHAGEAL PROSTHESIS, WITH OR WITHOUT VALVE, REPLACEMENT ONLY, EACH",99.0,49.5,29.7,121.79,28
CDM,7601251,UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES,334.0,167.0,100.2,454.24,28
CDM,7601252,UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES,377.0,188.5,113.1,512.72,28
CDM,7601258,"Evaluation of speech continuity, smoothness, rate, and effort",590.0,295.0,76.25,802.4,32
CDM,7601259,Evaluation of speech sound production,540.0,270.0,76.25,734.4,32
CDM,7601260,Evaluation of speech sound production with evaluation of language comprehension and expression,576.0,288.0,76.25,783.36,32
CDM,7601261,Analysis of voice and resonance production,544.0,272.0,76.25,739.84,32
CDM,7601266,"HEARING AID, DIGITAL, MONAURAL, CIC",1975.0,987.5,285.0,2686.0,28
CDM,7601267,"HEARING AID, DIGITAL, MONAURAL, ITC",1662.5,831.25,285.0,2261.0,28
CDM,7601268,"HEARING AID, DIGITAL, MONAURAL, ITE",3275.0,1637.5,285.0,4454.0,28
CDM,7601269,"HEARING AID, DIGITAL, MONAURAL, BTE",1817.0149999999999,908.51,285.0,2241.17,28
CDM,7601270,"HEARING AID, DIGITAL, BINAURAL, CIC",5407.14,2703.57,902.5,7353.71,28
CDM,7601271,"HEARING AID, DIGITAL, BINAURAL, ITC",3877.275,1938.635,902.5,5174.18,28
CDM,7601272,"HEARING AID, DIGITAL, BINAURAL, ITE",3350.0,1675.0,825.0,4147.5,28
CDM,7601273,"HEARING AID, DIGITAL, BINAURAL, BTE",3647.4300000000003,1823.7150000000001,902.5,4944.77,28
CDM,7601274,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",186.94,93.47,56.04,270.32,28
CDM,7601275,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",151.06,75.53,14.25,227.66,28
CDM,7601276,"EAR MOLD/INSERT, DISPOSABLE, ANY TYPE",20.625,10.315000000000001,6.0,28.9,28
CDM,7601294,"DISPENSING FEE, BINAURAL",250.0,125.0,38.31,340.0,32
CDM,7601297,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",250.0,125.0,38.31,340.0,32
CDM,7601299,REPAIR/MODIFICATION OF A HEARING AID,340.105,170.055,38.31,504.33,32
CDM,7601302,CONFORMITY EVALUATION,138.54,69.27,36.78,204.0,32
CDM,7601304,BATTERY FOR USE IN HEARING DEVICE,60.86,30.43,0.5,82.77,28
CDM,7601305,"HEARING SERVICE, MISCELLANEOUS",57.81,28.91,17.34,78.63,28
CDM,7601307,Handling and/or conveyance of device when created by an outside laboratory or specialty service,48.33,24.17,14.5,65.73,28
CDM,7601308,Test to assess the ability to complete specific functional tasks applicable to environment,417.0,208.5,102.65,776.84,32
CDM,7601312,UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES,646.0,323.0,193.8,878.56,28
CDM,7601313,UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES,903.0,451.5,270.9,1228.08,28
CDM,7601314,Test to assess balance during warm and cool irrigation in both ears,870.0,435.0,165.68,1183.2,32
CDM,7601315,Test to assess balance during warm or cool irrigation in both ears,821.0,410.5,172.78,1116.56,32
CDM,7601323,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",750.0,375.0,225.0,1020.0,28
CDM,7601324,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",932.145,466.07,289.29,1301.79,28
CDM,7601330,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",3525.0,1762.5,812.25,5270.0,56
CDM,7601333,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, GLASSES",450.0,225.0,135.0,739.9,28
CDM,7601334,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",250.0,125.0,38.31,340.0,32
CDM,7601336,"Therapy procedure for a range of mental processes, initial 15 minutes",144.0,72.0,21.9,195.84,32
CDM,7601337,"Therapy procedure for a range of mental processes, each additional 15 minutes",138.0,69.0,21.25,187.68,32
CDM,7601338,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,983.0,491.5,100.23,1336.88,32
CDM,7601341,Evaluation of brain response to sound for determination of hearing status with interpretation and report,650.0,325.0,100.23,884.0,32
CDM,7610012,Complex drainage of wound infection after surgery,4923.0,2461.5,1274.65,6695.28,32
CDM,7611016000,"Aspiration of abscess, blood, or cyst",925.0,462.5,207.21,1258.0,32
CDM,7611104200,"Removal of skin and tissue, 20.0 sq cm or less",1980.0,990.0,479.14,2692.8,32
CDM,7611104300,"Removal of muscle and/or tissue, 20.0 sq cm or less",2236.0,1118.0,479.14,3040.96,32
CDM,7611104400,"Removal of bone, 20.0 sq cm or less",3859.0,1929.5,1157.7,5248.24,32
CDM,7611104500,"Removal of skin and tissue, each additional 20.0 sq cm or less",1298.0,649.0,389.4,1765.28,32
CDM,7611104600,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",1827.0,913.5,548.1,2484.72,32
CDM,7611104700,"Removal of bone, each additional 20.0 sq cm or less",2094.0,1047.0,628.2,2847.84,32
CDM,7611110400,"Punch biopsy, first skin growth",1024.0,512.0,307.2,1392.64,32
CDM,7611120000,"Removal of skin tag, 1-15 skin tags",886.0,443.0,207.21,1204.96,32
CDM,7611172000,"Removal of fingernails or toenails, 1-5 nails",284.0,142.0,75.96,386.24,32
CDM,7611578100,Dermabrasion of skin of part of face,2200.0,1100.0,660.0,2992.0,32
CDM,7611602000,"Dressing change or removal of burn tissue, less than 5% of total body surface",673.0,336.5,201.9,915.28,32
CDM,7611725000,Application of chemical to stop tissue regrowth in wound,765.0,382.5,207.21,1040.4,32
CDM,7612055200,"Injection of trigger points, 1-2 muscles",1034.0,517.0,308.97,1406.24,32
CDM,7612908600,Application of finger cast,520.0,260.0,156.0,707.2,32
CDM,7613123100,Diagnostic exam of nasal passages using an endoscope,1085.0,542.5,212.62,1475.6,32
CDM,7613123800,Control of bleeding of nose using an endoscope,6964.0,3482.0,2089.2,9471.04,32
CDM,7613157500,Diagnostic exam of voice box using a flexible endoscope,1086.0,543.0,212.62,1476.96,32
CDM,7613641001,Insertion of needle into vein (3 years or older),172.0,86.0,10.99,233.92,32
CDM,7613659300,Declotting of central venous tube,1032.0,516.0,309.6,1403.52,32
CDM,7614110000,Biopsy of front 2/3 of tongue,2443.0,1221.5,212.62,3322.48,32
CDM,7614270000,Drainage of abscess near tonsil,1244.0,622.0,212.62,1691.84,32
CDM,7615170000,Simple bladder irrigation and/or instillation,1033.0,516.5,108.16,1404.88,32
CDM,7615170100,Insertion of temporary bladder tube,479.0,239.5,108.16,651.44,32
CDM,7615170200,Simple insertion of temporary bladder tube,344.0,172.0,103.2,467.84,32
CDM,7615170300,Complicated insertion of bladder tube,642.0,321.0,108.16,873.12,32
CDM,7615179800,Ultrasound measurement of bladder capacity after voiding,342.0,171.0,75.96,465.12,32
CDM,7615589900,Other procedure on male genital system,1013.0,506.5,303.9,3148.04,32
CDM,7616920900,Removal of impacted ear wax by washing,225.0,112.5,67.5,306.0,28
CDM,7616920901,Removal of impacted ear wax by washing,338.0,169.0,75.96,459.68,28
CDM,7616921000,Removal of impacted ear wax,253.0,126.5,75.9,344.08,28
CDM,7616921001,Removal of impacted ear wax,380.0,190.0,75.96,516.8,28
CDM,7619759700,"Removal of tissue from wound, 20.0 sq cm or less",623.0,311.5,186.9,847.28,32
CDM,7619759800,"Removal of tissue from wound, each additional 20.0 sq cm",597.0,298.5,25.18,1351.13,32
CDM,7631006,Placement of skin electrodes and measurement of stimulated sites in arms,1174.0,587.0,66.16,1596.64,32
CDM,7631011,Measurement of nerve conduction using visual stimulation testing with report,1216.0,608.0,52.71,1653.76,32
CDM,7631013,Placement of skin electrodes and measurement of stimulated sites in legs,1042.0,521.0,118.87,1417.12,32
CDM,7631017,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",1591.0,795.5,415.87,2163.76,32
CDM,7632003,Measurement of brain wave activity (EEG) during surgery,3525.0,1762.5,415.87,4794.0,32
CDM,7632051,"Measurement of brain wave activity (EEG), awake and drowsy",1353.0,676.5,110.63,1840.08,32
CDM,7632052,"Measurement of brain wave activity (EEG), awake and asleep",1494.0,747.0,102.02,2031.84,32
CDM,7632053,"Measurement of brain wave activity (EEG), in coma or asleep",1500.0,750.0,278.02,2040.0,32
CDM,7632054,"Measurement of brain wave activity (EEG), 41-60 minutes",1892.0,946.0,128.96,2573.12,32
CDM,7632055,"Measurement of brain wave activity (EEG), 61-119 minutes",2960.0,1480.0,278.02,4025.6,32
CDM,7632059,"Measurement of brain wave activity (EEG), continuous",980.0,490.0,278.02,1332.8,32
CDM,7632066,"Measurement of brain wave activity with video (VEEG), 2-12 hours",2850.0,1425.0,278.02,3876.0,32
CDM,7632067,"Measurement of brain wave activity with video (VEEG), 2-12 hours with intermittent monitoring",3500.0,1750.0,415.87,4760.0,32
CDM,7632068,"Measurement of brain wave activity with video (VEEG), 2-12 hours with continuous monitoring",3800.0,1900.0,415.87,5168.0,32
CDM,7632069,"Measurement of brain wave activity with video (VEEG), 12-26 hours",3375.0,1687.5,480.47,4590.0,32
CDM,7632071,"Measurement of brain wave activity with video (VEEG), 12-26 hours with continuous monitoring",4206.0,2103.0,562.51,5720.16,32
CDM,7661001,Complete ultrasound of within the brain blood flow,1344.0,672.0,211.36,1827.84,32
CDM,7719047100,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,7719047101,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,7719047102,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,7719047103,Administration of vaccine,149.0,74.5,44.7,202.64,32
CDM,7719047200,"Administration of vaccine, each additional vaccine",120.0,60.0,36.0,163.2,32
CDM,7719048000,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",120.0,60.0,36.0,163.2,32
CDM,7741011,Sleep study in sleep lab (6 years or older),6060.0,3030.0,443.39,8241.6,32
CDM,7741041,"Sleep study including heart rate, breathing, airflow, and effort",1348.0,674.0,190.54,1833.28,32
CDM,7741042,Sleep study in sleep lab with continuous airway pressure (6 years or older),7095.0,3547.5,505.43,9649.2,32
CDM,7741043,"Sleep study including heart rate, breathing, airflow, and effort",1348.0,674.0,190.54,1833.28,32
CDM,7741046,"Sleep study including heart rate, breathing, and sleep time",1153.0,576.5,190.54,1568.08,32
CDM,7771004,Other ultrasound procedure,1020.0,510.0,39.84,1387.2,32
CDM,7771006,Follow-up ultrasound scan of fetal heart,1310.0,655.0,43.74,1781.6,32
CDM,7771007,Follow-up ultrasound scan of fetal heart blood flow,882.0,441.0,46.74,1199.52,32
CDM,7771008,Ultrasound scan of fetal heart blood flow,1411.0,705.5,87.03,1918.96,32
CDM,7771020,Ultrasound of heart for congenital defect,2892.0,1446.0,543.5,3933.12,32
CDM,7771021,"Ultrasound of heart for congenital defect, follow-up",1720.0,860.0,516.0,2339.2,32
CDM,7801038,Sleep study in sleep lab (younger than 6 years),5264.0,2632.0,505.43,7159.04,32
CDM,7801039,Sleep study in sleep lab with continuous airway pressure (younger than 6 years),5820.0,2910.0,505.43,7915.2,32
CDM,7801040,Assessment of health behavior,285.0,142.5,85.5,387.6,30
CDM,7801041,"Treatment of behavior impacting health, initial 30 minutes",339.0,169.5,101.7,461.04,30
CDM,7801042,"Treatment of behavior impacting health, each additional 15 minutes",250.0,125.0,75.0,340.0,26
CDM,7801045,"Treatment of behavior impacting health with family and patient, initial 30 minutes",156.0,78.0,46.8,224.23,30
CDM,7801046,"Treatment of behavior impacting health with family and patient, each additional 30 minutes",90.0,45.0,27.0,122.4,26
CDM,7811176,Transplantation of donor stem cells per donor,92477.0,46238.5,5568.9,125768.72,32
CDM,7811177,Transplantation of patient-derived stem cells,6160.0,3080.0,1848.0,8377.6,32
CDM,7811179,HB CHIMERIC ANTIGEN RECEPTOR (CAR) T,2961420.0,1480710.0,740355.0,1954537.2,14
CDM,7811181,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",1988949.0,994474.5,56281.85,2704970.64,29
CDM,7821003,Test to measure rate of airflow,551.0,275.5,35.19,749.36,32
CDM,7821004,Other service or procedure on lung,451.0,225.5,22.33,613.36,32
CDM,7821023,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,32
CDM,7821024,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,32
CDM,7841018,"Exam of neurobehavioral status, first hour",1003.0,501.5,278.02,1364.08,32
CDM,7841020,"Test to assess the loss of the ability to speak, write, and understand language",422.0,211.0,96.99,776.84,32
CDM,7841028,"Administration of developmental test, first hour",507.0,253.5,152.1,776.84,32
CDM,7841029,"Administration of developmental test, each additional 30 minutes",352.0,176.0,105.6,776.84,32
CDM,7841030,"Evaluation of psychological test, first hour",685.0,342.5,205.5,931.6,32
CDM,7841031,"Evaluation of psychological test, each additional hour",663.0,331.5,198.9,901.68,32
CDM,7841032,"Evaluation of neuropsychological test, first hour",838.0,419.0,251.4,1139.68,32
CDM,7841033,"Evaluation of neuropsychological test, each additional hour",569.0,284.5,170.7,776.84,32
CDM,7841034,"Administration of psychological or neuropsychological test, first 30 minutes",431.0,215.5,129.3,776.84,32
CDM,7841035,"Administration of psychological or neuropsychological test, each additional 30 minutes",365.0,182.5,109.5,776.84,32
CDM,7841036,"Administration of psychological or neuropsychological test by technician, first 30 minutes",624.0,312.0,187.2,848.64,32
CDM,7841037,"Administration of psychological or neuropsychological test by technician, each additional 30 minutes",369.0,184.5,110.7,776.84,32
CDM,7901037,"Training for community or work reintegration, each 15 minutes",144.0,72.0,32.5,195.84,32
CDM,7931003,Group psychotherapy,839.0,419.5,130.81,1141.04,30
CDM,7931004,Group psychotherapy,349.0,174.5,104.7,474.64,30
CDM,7931008,Group psychotherapy,349.0,174.5,104.7,474.64,30
CDM,7931010,"ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR RECREATION, RELATED TO THE CARE AND TREATMENT OF PATIENT'S DISABLING MENTAL HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE)",470.0,235.0,141.0,639.2,30
CDM,7941004,Ultrasound exam of esophagus using a flexible endoscope,8175.0,4087.5,1210.47,11118.0,32
CDM,7941005,Ultrasound guided fine needle aspiration or biopsy of esophagus using a flexible endoscope,8995.0,4497.5,1210.47,12233.2,32
CDM,7941006,Injection beneath lining of lower large bowel using a flexible endoscope,4522.0,2261.0,1197.41,6149.92,32
CDM,7941007,Ultrasound exam of lower large bowel using a flexible endoscope,4945.0,2472.5,1197.41,6725.2,32
CDM,7941008,Fine needle aspiration and/or biopsy of lower large bowel with ultrasound guidance using a flexible endoscope,5217.0,2608.5,1236.88,7095.12,32
CDM,7941009,Insertion of stent into lower large bowel using a flexible endoscope,6575.0,3287.5,1972.5,8942.0,32
CDM,7941011,Biopsy of esophagus using a flexible endoscope through mouth,3410.0,1705.0,1023.0,4637.6,32
CDM,7941013,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth",6695.0,3347.5,1210.47,9105.2,32
CDM,7941014,Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope,6058.0,3029.0,1210.47,8238.88,32
CDM,7941097,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",144.0,72.0,31.39,195.84,32
CDM,7941099,Biopsy of voice box using a flexible endoscope,5695.0,2847.5,1708.5,7745.2,32
CDM,7941106,Snip incision of tear duct at inner corner of eye,1012.0,506.0,303.6,1376.32,32
CDM,7941115,Application of hot or cold packs,71.0,35.5,15.7,96.56,32
CDM,7941116,Administration of medication through breathing tube,464.0,232.0,72.29,631.04,32
CDM,7941120,"Medical team conference with patient and/or family, and nonphysician health care professionals, 30 minutes or more",85.0,42.5,25.5,144.65,32
CDM,7941121,"Medical team conference with physician, 30 minutes or more",85.0,42.5,25.5,144.65,32
CDM,7941127,Revision or repair of operative wound of eye,5470.0,2735.0,1264.82,7439.2,32
CDM,7941128,Removal of outer layer of cornea,1774.0,887.0,532.2,2412.64,32
CDM,7941133,Insertion of needles or tubes into pelvic or genital organs for radiation therapy,7719.0,3859.5,2315.7,10497.84,32
CDM,7941134,Insertion of device into uterus for radiation therapy,9715.0,4857.5,2914.5,13212.4,32
CDM,7941137,Insertion of defibrillator with existing single lead,35098.0,17549.0,10529.4,47733.28,32
CDM,7941138,Insertion of implantable defibrillator system,50150.0,25075.0,15045.0,68204.0,32
CDM,7941140,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED ST",2075.0,1037.5,449.2,2822.0,32
CDM,7941141,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEME",3545.0,1772.5,543.5,4821.2,32
CDM,7941142,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOV",4513.0,2256.5,543.5,6137.68,32
CDM,7941143,"Therapy procedure using manual technique, each 15 minutes",178.0,89.0,27.9,242.08,32
CDM,7941146,"Therapy procedure using manual technique, each 15 minutes",178.0,89.0,27.9,242.08,32
CDM,7941149,Interpretation and report of ultrasound of heart,2602.0,1301.0,543.5,3538.72,32
CDM,7941156,Removal of foreign body in lung airways using an endoscope,4936.0,2468.0,1480.8,6712.96,32
CDM,7941157,Repair of wound of eyelid margin,5905.0,2952.5,1659.96,8030.8,32
CDM,7941164,Removal of eyelashes,1060.0,530.0,318.0,1441.6,32
CDM,7941166,Biopsy of cervix or removal of growth,2415.0,1207.5,667.43,3284.4,32
CDM,7941171,Measurement of bilirubin,32.0,16.0,1.61,43.52,32
CDM,7941207,Incision of fluid canal of inner ear with infusion of drugs,4513.0,2256.5,1353.9,6137.68,32
CDM,7941208,Incision of eardrum with insertion of eardrum tube under local or topical anesthesia,3558.0,1779.0,212.62,4838.88,32
CDM,7941211,Simple removal of skin debris and drainage of mastoid cavity,880.0,440.0,212.62,1196.8,32
CDM,7941212,Complex removal of skin debris and drainage of mastoid cavity,4104.0,2052.0,694.44,5581.44,32
CDM,7941213,"Incision, aspiration, and/or inflation of eardrum",1893.0,946.5,212.62,2574.48,32
CDM,7941214,Repair of eardrum,4389.0,2194.5,1316.7,5969.04,32
CDM,7941215,Removal of foreign body in ear canal,428.0,214.0,128.4,582.08,28
CDM,7941219,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",4000.0,2000.0,543.5,5440.0,32
CDM,7941220,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",5500.0,2750.0,543.5,7480.0,32
CDM,7941224,Exam of common bile and/or pancreatic duct using a flexible endoscope,3890.0,1945.0,1167.0,5667.91,32
CDM,7941225,Physician attendance at delivery and stabilization of newborn,525.0,262.5,157.5,714.0,28
CDM,7941226,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",300.0,150.0,45.43,408.0,32
CDM,7941227,"Evaluation of single, dual, multiple lead or leadless pacemaker system",612.0,306.0,45.43,832.32,32
CDM,7941229,Programming of dual lead pacemaker system,488.0,244.0,45.43,663.68,32
CDM,7941230,Programming of multiple lead pacemaker system,496.0,248.0,45.43,674.56,32
CDM,7941231,Programming of dual lead implantable defibrillator system,961.0,480.5,45.43,1306.96,32
CDM,7941232,Programming of multiple lead implantable defibrillator system,1030.0,515.0,45.43,1400.8,32
CDM,7941233,"Evaluation of single, dual, or multiple lead implantable defibrillator system",650.0,325.0,45.43,884.0,32
CDM,7941234,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",575.0,287.5,45.43,782.0,32
CDM,7941235,Programming of cardiac rhythm monitor system,388.0,194.0,45.43,527.68,32
CDM,7941236,Evaluation of cardiac rhythm monitor system,602.0,301.0,37.24,818.72,32
CDM,7941238,Programming of single lead pacemaker system,421.0,210.5,45.43,572.56,32
CDM,7941239,Programming of single lead implantable defibrillator system,874.0,437.0,45.43,1188.64,32
CDM,7941240,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",410.0,205.0,45.43,557.6,32
CDM,7941243,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL",4934.0,2467.0,543.5,6710.24,32
CDM,7941244,Insertion of blood flow assist device in aorta through skin,4295.0,2147.5,1288.5,10468.22,64
CDM,7941273,HB OXYGENATOR,3917.0,1958.5,979.25,2585.22,16
CDM,7941293,"Treatment using magnetic field to stimulate nerve cells in brain, initial delivery and management",839.0,419.5,251.7,1141.04,32
CDM,7941294,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management",1013.0,506.5,278.02,1377.68,32
CDM,7941298,Insertion of needle for infusion into bone,861.0,430.5,258.3,1170.96,32
CDM,7941301,Removal of tissue from wound gradually,415.0,207.5,124.5,564.4,32
CDM,7941302,Repair of perforating laceration of cornea and/or sclera with reposition or removal of uveal tissue,8875.0,4437.5,2662.5,12070.0,32
CDM,7941306,Initial control of nose bleed and insertion of packing,863.0,431.5,171.32,1173.68,32
CDM,7941308,Removal or destruction of growth of nose through nose,6430.0,3215.0,1929.0,8744.8,32
CDM,7941310,Biopsy of saliva gland,5304.0,2652.0,1591.2,7213.44,32
CDM,7941311,Complex control of nose bleed,857.0,428.5,171.32,1165.52,32
CDM,7941312,"Removal of growth of eyelid lining, more than 1.0 cm",5533.0,2766.5,1659.9,7524.88,32
CDM,7941326,Biopsy of roof of mouth,2782.0,1391.0,834.6,3783.52,32
CDM,7941327,Biopsy of floor of mouth,2533.0,1266.5,759.9,3444.88,32
CDM,7941330,Evaluation of eye adaptation to light and dark with interpretation and report,980.0,490.0,94.55,1332.8,32
CDM,7941331,Placement of hormone pellet under skin,818.0,409.0,245.4,1112.48,32
CDM,7941333,Exam of ear using a microscope,241.0,120.5,72.3,327.76,28
CDM,7941334,"Repositioning exercises of head for treatment of dizziness, each day",295.0,147.5,35.65,401.2,32
CDM,7941342,Imaging of front third of eye,372.0,186.0,70.21,505.92,32
CDM,7941343,Suture of recent wound of eyelid,5224.0,2612.0,1567.2,7104.64,32
CDM,7941346,Imaging of optic nerve,340.0,170.0,70.21,462.4,32
CDM,7941347,Imaging of retina,358.0,179.0,70.21,486.88,32
CDM,7941351,Injection for nonselective imaging of pulmonary artery during heart catheterization,2850.0,1425.0,411.09,3876.0,32
CDM,7941352,Injection for imaging of right heart chambers with review by radiologist,1581.0,790.5,411.09,2150.16,32
CDM,7941354,Injection for imaging of aorta above heart valve with review by radiologist,2517.0,1258.5,411.09,3423.12,32
CDM,7941355,Injection for imaging of coronary blood vessel during evaluation of congenital abnormalities with review by radiologist,3141.0,1570.5,411.09,4271.76,32
CDM,7941357,Insertion of tube in right heart chambers for measurement,13125.0,6562.5,3027.8,17850.0,32
CDM,7941358,Insertion of tube in left heart chambers for diagnosis with review by radiologist,14375.0,7187.5,3027.8,19550.0,32
CDM,7941359,Insertion of tube in right and left heart chambers for diagnosis with review by radiologist,13825.0,6912.5,3027.8,18802.0,32
CDM,7941360,Insertion of tube in coronary artery for diagnosis with review by radiologist,11501.0,5750.5,3027.8,15641.36,32
CDM,7941361,Insertion of tube in bypass graft for diagnosis with review by radiologist,12621.0,6310.5,3027.8,17164.56,32
CDM,7941362,Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist,15950.0,7975.0,3027.8,21692.0,32
CDM,7941363,"Insertion of tube in right heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",19228.0,9614.0,3027.8,26150.08,32
CDM,7941364,Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist,18463.0,9231.5,3027.8,25109.68,32
CDM,7941365,"Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist",19435.0,9717.5,3027.8,26431.6,32
CDM,7941366,Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist,15015.0,7507.5,3027.8,20420.4,32
CDM,7941367,"Insertion of tube in right and left heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",16556.0,8278.0,3027.8,22516.16,32
CDM,7941368,Drug infusion during cardiac catheterization,1814.0,907.0,58.14,2467.04,32
CDM,7941371,HB REVOLUTION PUMP,449.0,224.5,112.25,296.34,16
CDM,7941373,"Repositioning exercises of head for treatment of dizziness, each day",295.0,147.5,35.65,401.2,32
CDM,7941376,1D and 2D ultrasound scan of eye tissue and structures,668.0,334.0,137.18,908.48,32
CDM,7941386,"Test of car seat or bed (1 year or younger), 1 hour",230.0,115.0,48.09,312.8,32
CDM,7941387,"Test of car seat or bed (1 year or younger), each additional 30 minutes",115.0,57.5,34.5,156.4,32
CDM,7941389,Removal and replacement of single lead permanent pacemaker,14235.0,7117.5,4270.5,19359.6,32
CDM,7941390,Removal and replacement of dual lead permanent pacemaker,23100.0,11550.0,6930.0,31416.0,32
CDM,7941391,Removal and replacement of multiple lead permanent pacemaker,29820.0,14910.0,8946.0,40555.2,32
CDM,7941393,Insertion of defibrillator with existing multiple leads,50132.0,25066.0,15039.6,68179.52,32
CDM,7941394,Removal and replacement of single lead defibrillator,50554.0,25277.0,15166.2,68753.44,32
CDM,7941395,Removal and replacement of dual lead defibrillator,52572.0,26286.0,15771.6,71497.92,32
CDM,7941396,Removal and replacement of multiple lead defibrillator,55560.0,27780.0,16668.0,75561.6,32
CDM,7941397,Drainage of fluid from abdominal cavity,2098.0,1049.0,629.4,2853.28,32
CDM,7941399,Drainage of fluid from abdominal cavity using imaging guidance,2605.0,1302.5,781.5,3542.8,32
CDM,7941409,Replacement of aortic valve through the skin and femoral artery,25731.0,12865.5,7719.3,34994.16,32
CDM,7941413,Insertion of tube in peripheral blood vessel accessed through skin for heart-lung machine support,18250.0,9125.0,5475.0,24820.0,32
CDM,7941416,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,3300.0,1650.0,990.0,4488.0,32
CDM,7941423,HB ECMO CIRCUIT 3/8 ADULT,1809.0,904.5,452.25,1193.94,16
CDM,7941460,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,4200.0,2100.0,1260.0,9235.95,32
CDM,7941461,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,4500.0,2250.0,1350.0,9235.95,32
CDM,7941462,Daily management of ECMO external vein to vein blood circulation in heart and lungs using a pump,2250.0,1125.0,675.0,9235.95,32
CDM,7941463,Daily management of ECMO external vein to artery blood circulation in heart and lungs using a pump,2250.0,1125.0,675.0,9235.95,32
CDM,7941494,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE",3088.0,1544.0,543.5,4199.68,32
CDM,7941495,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY",2194.0,1097.0,543.5,2983.84,32
CDM,7941509,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",53361.0,26680.5,10292.35,72570.96,32
CDM,7941516,Removal of sutures or staples,338.0,169.0,101.4,459.68,28
CDM,7951015,"Psychotherapy with evaluation and management visit, 1 hour",500.0,250.0,150.0,680.0,30
CDM,7951022,Measurement of retinal and optic nerve function,864.0,432.0,94.55,1175.04,32
CDM,7951023,Measurement of retinal and optic nerve function targeting multiple separate locations,590.0,295.0,94.55,802.4,32
CDM,7951028,Removal of up to 1/4 of eyelid margin and repair of eyelid,5262.0,2631.0,1578.6,7156.32,32
CDM,8001005,"Family psychotherapy with patient, 50 minutes",516.0,258.0,154.8,701.76,30
CDM,8001020,"Family psychotherapy without patient, 50 minutes",495.0,247.5,148.5,673.2,30
CDM,8001035,"Smoking and tobacco use intermediate counseling, 3-10 minutes",87.0,43.5,26.1,118.32,32
CDM,8001036,"Smoking and tobacco use intensive counseling, more than 10 minutes",100.0,50.0,28.93,136.0,32
CDM,8001037,Psychiatric services complicated by communication factor,202.0,101.0,60.6,274.72,30
CDM,8001038,Psychiatric diagnostic evaluation,635.0,317.5,190.5,863.6,62
CDM,8001039,Psychiatric diagnostic evaluation with medical services,685.0,342.5,205.5,931.6,62
CDM,8001040,"Psychotherapy, 30 minutes",395.0,197.5,118.5,537.2,30
CDM,8001041,"Psychotherapy with evaluation and management visit, 30 minutes",455.0,227.5,136.5,618.8,30
CDM,8001042,"Psychotherapy, 45 minutes",497.0,248.5,149.1,675.92,30
CDM,8001043,"Psychotherapy with evaluation and management visit, 45 minutes",497.0,248.5,149.1,675.92,30
CDM,8001044,"Psychotherapy, 1 hour",516.0,258.0,154.8,701.76,30
CDM,8001045,"Psychotherapy with evaluation and management visit, 1 hour",500.0,250.0,150.0,680.0,30
CDM,8001046,"Psychotherapy for crisis, first hour",938.0,469.0,193.96,1275.68,30
CDM,8001047,"Psychotherapy for crisis, each additional 30 minutes",280.0,140.0,84.0,380.8,30
CDM,8001050,Assessment of emotional or behavioral problems,155.0,77.5,28.93,210.8,32
CDM,8001054,Psychiatric diagnostic evaluation,90.0,45.0,27.0,330.38,60
CDM,8001056,"Psychotherapy, 45 minutes",52.0,26.0,15.6,228.54,30
CDM,8009094500,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,32
CDM,8019093500,Hemodialysis procedure with physician evaluation,1685.0,842.5,505.5,2291.6,32
CDM,8029094500,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,32
CDM,8049094500,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,32
CDM,8299093500,Hemodialysis procedure with physician evaluation,2500.0,1250.0,750.0,3400.0,32
CDM,8431001,Electrocardiogram (ECG) 2-day continuous,1162.0,581.0,77.51,1580.32,32
CDM,8431006,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,629.0,314.5,48.05,855.44,32
CDM,8501003,Balloon dilation repair of aortic valve,9310.0,4655.0,2793.0,12661.6,32
CDM,8501044,Manual attempt to restore blood circulation and breathing,1374.0,687.0,278.02,1868.64,32
CDM,8501053,Biopsy of heart muscle,6984.0,3492.0,2095.2,9498.24,32
CDM,8501085,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel",4694.0,2347.0,1408.2,6383.84,32
CDM,8501101,Insertion of tube in upper and/or lower heart chambers to record and identify origin of abnormal heart rhythm,7261.0,3630.5,971.89,23251.95,32
CDM,8501143,Balloon dilation repair of pulmonary valve,17909.0,8954.5,5372.7,24356.24,32
CDM,8501168,Insertion of tube in pulmonary artery for monitoring,2429.0,1214.5,728.7,3303.44,32
CDM,8501293,Balloon dilation repair of mitral valve,19897.0,9948.5,5969.1,27059.92,32
CDM,8501294,"Balloon dilation of pulmonary artery, single vessel",17732.0,8866.0,5319.6,24115.52,32
CDM,8501648,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",6944.0,3472.0,253.72,9443.84,32
CDM,8501650,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",3817.0,1908.5,253.72,5191.12,32
CDM,8501679,Removal of blood clot in heart artery,4000.0,2000.0,1200.0,10909.9,32
CDM,8501688,Repair of congenital abnormality in wall between upper heart chambers with implant,31250.0,15625.0,9375.0,42500.0,32
CDM,8501689,Repair of congenital abnormality in wall between lower heart chambers with implant,28359.0,14179.5,8507.7,38568.24,32
CDM,8501699,"ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES POSI",3130.0,1565.0,939.0,5880.39,32
CDM,8501771,Imaging of organ,302.0,151.0,67.28,410.72,32
CDM,8501783,Balloon dilation of single coronary artery or branch,14942.0,7471.0,4482.6,20321.12,32
CDM,8501785,Removal of plaque with balloon dilation of single coronary artery or branch,20832.0,10416.0,6249.6,28331.52,32
CDM,8501787,"Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch",19505.0,9752.5,5851.5,26526.8,32
CDM,8501789,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",28118.0,14059.0,8435.4,38240.48,32
CDM,8501791,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",19505.0,9752.5,5851.5,26526.8,32
CDM,8501793,"Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel",18506.0,9253.0,5551.8,25168.16,32
CDM,8501794,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft",19505.0,9752.5,5851.5,26526.8,32
CDM,8501796,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",28078.0,14039.0,8423.4,38186.08,32
CDM,8501798,Retrieval of foreign body in blood vessel with review by radiologist,6012.0,3006.0,1803.6,8176.32,32
CDM,8501799,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",8500.0,4250.0,2550.0,11560.0,32
CDM,8501800,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",5264.0,2632.0,1579.2,7159.04,32
CDM,8501801,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,5001.0,2500.5,1500.3,6801.36,32
CDM,8501802,Removal of tube into artery or vein with review by radiologist,6039.0,3019.5,1811.7,8213.04,32
CDM,8501803,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,6291.0,3145.5,1887.3,39253.76,32
CDM,8501805,Removal of blood flow assist device in left lower heart chamber through the skin,5368.0,2684.0,1610.4,9612.57,32
CDM,8501806,Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist,9978.0,4989.0,2993.4,13570.08,32
CDM,8501807,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,10479.0,5239.5,3143.7,14251.44,32
CDM,8501808,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,10383.0,5191.5,3114.9,14120.88,32
CDM,8501811,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,15129.0,7564.5,4538.7,20575.44,32
CDM,8501812,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,16936.0,8468.0,5080.8,23032.96,32
CDM,8501814,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",20625.0,10312.5,6187.5,28050.0,32
CDM,8501815,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG-ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO",18497.0,9248.5,5549.1,25155.92,32
CDM,8501816,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",28359.0,14179.5,8507.7,38568.24,32
CDM,8501818,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",29329.0,14664.5,8798.7,39887.44,32
CDM,8501819,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",18142.0,9071.0,5442.6,24673.12,32
CDM,8501820,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRA",19250.0,9625.0,5775.0,26180.0,32
CDM,8501823,"Repair of mitral valve through the skin, initial prosthesis",12132.0,6066.0,3639.6,19194.56,32
CDM,8501824,"Repair of mitral valve through the skin, additional prosthesis",5500.0,2750.0,1650.0,19194.56,32
CDM,8501832,Repair of left upper heart chamber with implant with review by radiologist,28500.0,14250.0,8550.0,38760.0,32
CDM,8501835,"Repair of leak adjacent to mitral valve, first closure device",42203.0,21101.5,12660.9,57396.08,32
CDM,8501837,"Repair of lead adjacent to heart valve, each additional closure device",29335.0,14667.5,8800.5,39895.6,32
CDM,8501839,Emergent insertion of breathing tube into windpipe using an endoscope,920.0,460.0,276.0,1251.2,32
CDM,8501840,Ultrasonic guidance for blood vessel access,715.0,357.5,54.02,972.4,32
CDM,8501842,"Insertion of artificial valve between left heart chambers, accessed through the skin",90000.0,45000.0,18108.06,122400.0,32
CDM,8501843,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",10500.0,5250.0,3027.8,14280.0,32
CDM,8501844,"Repair of leak adjacent to aortic valve, first closure device",34848.0,17424.0,10454.4,47393.28,32
CDM,8501845,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",2468.0,1234.0,740.4,3356.48,32
CDM,8501846,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",4302.0,2151.0,1290.6,5850.72,32
CDM,8501847,Insertion of permanent leadless pacemaker using imaging guidance,44900.0,22450.0,9875.67,61064.0,32
CDM,8501848,Removal of permanent leadless pacemaker using imaging guidance,7144.0,3572.0,2143.2,9715.84,32
CDM,8501849,Insertion of heart rhythm monitor under skin,14235.0,7117.5,4270.5,19359.6,32
CDM,8501850,Removal of heart rhythm monitor from under the skin,7193.0,3596.5,911.78,9782.48,32
CDM,8501851,Dilation of existing opening into urinary tract using imaging guidance,5393.0,2696.5,1617.9,7334.48,32
CDM,8501854,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,67782.0,33891.0,20334.6,92183.52,32
CDM,8501857,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",13058.0,6529.0,3027.8,17758.88,32
CDM,8501859,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",12250.0,6125.0,3027.8,16660.0,32
CDM,8501860,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",14812.0,7406.0,3027.8,20144.32,32
CDM,8561011,External shock to heart to regulate heart beat,2956.0,1478.0,777.75,4020.16,32
CDM,8561012,Destruction of heart conduction tissue to create heart block,13052.0,6526.0,3915.6,23251.95,32
CDM,8561015,Insertion of catheters for recording and pacing of right heart chambers rhythm and induction of abnormal rhythm,20771.0,10385.5,1635.59,28248.56,32
CDM,8561020,Routine electrocardiogram (ECG) using at least 12 leads with tracing,453.0,226.5,32.27,616.08,32
CDM,8561025,Insertion of catheters for recording and pacing of left lower heart chamber rhythm and induction of abnormal rhythm,13071.0,6535.5,3921.3,17776.56,32
CDM,8561030,Programming of pacing cardioverter-defibrillator,5873.0,2936.5,1567.7,8475.93,32
CDM,8561032,Insertion of pacemaker pulse generator with existing single lead,14235.0,7117.5,4270.5,19359.6,32
CDM,8561033,Insertion of pacemaker and upper and lower heart chamber electrode,20903.0,10451.5,6270.9,28428.08,32
CDM,8561034,Insertion of pacemaker and lower heart chamber electrode,18000.0,9000.0,5400.0,24480.0,32
CDM,8561035,Insertion of pacemaker and upper heart chamber electrode,18000.0,9000.0,5400.0,24480.0,32
CDM,8561037,Insertion of 2 electrodes for permanent pacemaker or defibrillator,12941.0,6470.5,1968.66,17599.76,32
CDM,8561038,Insertion of 1 electrode for permanent pacemaker or defibrillator,12941.0,6470.5,1968.66,17599.76,32
CDM,8561044,Insertion of blood flow assist device in aorta through skin,4295.0,2147.5,1288.5,10468.22,32
CDM,8561051,Insertion of temporary pacemaker lead in single heart chamber,12941.0,6470.5,1968.66,17599.76,32
CDM,8561055,Programming of heart rhythm stimulation after drug infusion,12074.0,6037.0,3622.2,16420.64,32
CDM,8561058,Removal of defibrillator electrodes through vein,11538.0,5769.0,1968.66,15691.68,32
CDM,8561059,Removal of defibrillator,6260.0,3130.0,1878.0,9612.57,32
CDM,8561060,Removal of permanent pacemaker pulse generator,17506.0,8753.0,5251.8,23808.16,32
CDM,8561061,Removal of dual electrodes from right heart,12096.0,6048.0,1968.66,16450.56,32
CDM,8561062,Removal of single electrode from right heart,6576.0,3288.0,1968.66,8943.36,32
CDM,8561067,Relocation of defibrillator skin pocket,4619.0,2309.5,1385.7,6281.84,32
CDM,8561068,Relocation of pacemaker skin pocket,4004.0,2002.0,1201.2,5445.44,32
CDM,8561072,Recording of right lower heart chamber rhythm,2500.0,1250.0,750.0,8475.93,32
CDM,8561078,Evaluation of heart function using tilt table,4117.0,2058.5,208.02,5599.12,32
CDM,8561103,Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement,4052.0,2026.0,1215.6,8475.93,32
CDM,8561112,Ultrasound evaluation of heart blood vessel with review by radiologist,8425.0,4212.5,543.5,11458.0,32
CDM,8561113,Insertion of left lower heart electrode and attachment to pacemaker or defibrillator,20210.0,10105.0,6063.0,27485.6,32
CDM,8561114,Insertion of left lower heart electrode for pacemaker or defibrillator,34544.0,17272.0,9875.67,46979.84,32
CDM,8561116,Repositioning of pacemaker or defibrillator electrode,6654.0,3327.0,1968.66,9049.44,32
CDM,8561122,Insertion of tube for 3D mapping of electrical impulses to heart muscle,13657.0,6828.5,4097.1,18573.52,32
CDM,8562197,Insertion of tube in left heart chamber through heart septum,12994.0,6497.0,3027.8,17671.84,32
CDM,8562203,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate),48880.0,24440.0,3193.49,66476.8,32
CDM,8562204,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heart,50250.0,25125.0,15075.0,68340.0,32
CDM,8562205,Insertion of catheters and destruction of tissue to treat abnormal heart rhythm,25323.0,12661.5,7596.9,34439.28,32
CDM,8562206,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation,50250.0,25125.0,3193.49,68340.0,32
CDM,8562207,Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm,22438.0,11219.0,6731.4,30515.68,32
CDM,8562218,Insertion of implantable defibrillator system,50150.0,25075.0,15045.0,68204.0,32
CDM,8562232,Insertion or replacement of defibrillator with electrode,66823.0,33411.5,20046.9,90879.28,32
CDM,8562234,Removal of defibrillator electrode,6576.0,3288.0,1968.66,8943.36,32
CDM,8562235,Repositioning of defibrillator electrode,6179.0,3089.5,1853.7,8403.44,32
CDM,8562236,Programming of implantable defibrillator,3520.0,1760.0,1056.0,8475.93,32
CDM,8562237,Evaluation of implantable defibrillator system,280.0,140.0,45.43,380.8,32
CDM,8562238,Programming of implantable defibrillator system,300.0,150.0,45.43,408.0,32
CDM,8562247,Repair of electrode for permanent pacemaker or defibrillator,11644.0,5822.0,1968.66,15835.84,32
CDM,8562251,Exposure of groin artery for delivery of graft,459.0,229.5,137.7,21839.3,32
CDM,8562266,Other cardiovascular service or procedure,820.0,410.0,32.27,1115.2,32
CDM,8591012,Electrocardiogram (ECG) 1 to 3 leads,217.0,108.5,31.44,295.12,32
CDM,8591013,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,897.0,448.5,48.09,1219.92,32
CDM,8591014,Heart rhythm recording of continuous external EKG over 8-15 days,900.0,450.0,48.09,1224.0,32
CDM,8621004,Diagnostic exam of lung airway using an endoscope,3730.0,1865.0,1119.0,5072.8,32
CDM,8621005,Initial therapy service to facilitate lung function,297.0,148.5,72.29,403.92,32
CDM,8621010,Initial hospital inpatient or observation ventilation assistance and management,1488.0,744.0,446.4,2023.68,32
CDM,8621011,Therapy procedure using a positive pressure ventilator,892.0,446.0,161.43,1213.12,32
CDM,8621051,Follow-up inpatient or observation ventilation assistance and management,1773.0,886.5,531.9,2411.28,32
CDM,8621052,Test to measure the total volume of air that can be exhaled after inhaling,342.0,171.0,18.81,465.12,32
CDM,8621057,Inhalation treatment for pneumonia,582.0,291.0,72.29,791.52,32
CDM,8621059,Biopsy of lung airway using an endoscope,4380.0,2190.0,1314.0,5956.8,32
CDM,8621062,Exam of lung airways using an endoscope,3500.0,1750.0,1050.0,4760.0,32
CDM,8621063,Irrigation and suction of lung airways to obtain cells using an endoscope,4180.0,2090.0,1254.0,5684.8,32
CDM,8621064,Aspiration of initial secretion of lung airway using an endoscope,4563.0,2281.5,1368.9,6205.68,32
CDM,8621065,Aspiration of subsequent secretions of lung airway using an endoscope during same hospital stay,3652.0,1826.0,503.61,4966.72,32
CDM,8621066,Follow-up therapy service to facilitate lung function,222.0,111.0,66.6,301.92,32
CDM,8621067,Test to measure oxygen level in blood using ear or finger device continuously overnight,270.0,135.0,21.81,367.2,32
CDM,8621070,"Biopsy of lobe of lung using an endoscope, 1 lobe",6143.0,3071.5,1842.9,8354.48,32
CDM,8621071,"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope",6405.0,3202.5,1921.5,8710.8,32
CDM,8621078,Evaluation of use of breathing device,424.0,212.0,13.7,576.64,32
CDM,8621084,"Inhalation treatment for acute airway obstruction, first hour",348.0,174.0,72.29,473.28,32
CDM,8621085,"Inhalation treatment for acute airway obstruction, each additional hour",174.0,87.0,52.2,236.64,32
CDM,8621087,HB NITRIC OXIDE PER HOUR,250.0,125.0,62.5,165.0,16
CDM,8621108,Therapy procedure to clear airway using an inflatable vest,318.0,159.0,72.29,432.48,32
CDM,8621110,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes",8250.0,4125.0,2475.0,11220.0,32
CDM,8621111,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes",8002.0,4001.0,2400.6,10882.72,32
CDM,8621112,Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound,4685.0,2342.5,1405.5,6371.6,32
CDM,8621113,Destruction of growth or narrowing of lung airway using an endoscope,7097.0,3548.5,2129.1,9651.92,32
CDM,8651004,Test to measure lung airway sensitivity,1618.0,809.0,100.95,2200.48,32
CDM,8651010,Test to measure lung function at high altitude,411.0,205.5,72.29,558.96,32
CDM,8651011,Test to measure oxygen level in blood using ear or finger device multiple times,349.0,174.5,26.03,474.64,28
CDM,8651015,Test to measure expiratory airflow and volume changes before and after medication administration,1083.0,541.5,75.59,1472.88,32
CDM,8651016,Test to measure expiratory airflow and volume,634.0,317.0,46.63,862.24,32
CDM,8651019,Test for exercise-induced heart and lung stress,2375.0,1187.5,129.52,3230.0,32
CDM,8651020,"Professional services for outpatient pulmonary rehabilitation, per session",272.0,136.0,15.31,369.92,32
CDM,8651021,"Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session",341.0,170.5,28.32,463.76,32
CDM,8651026,Test to measure oxygen level in blood using ear or finger device,109.25,54.63,15.75,148.58,28
CDM,8651033,Sweat collection,414.0,207.0,10.36,563.04,32
CDM,8651038,Test to measure lung function at high altitude with evaluation of oxygen needs at rest and during exercise,510.0,255.0,72.29,693.6,32
CDM,8651045,Test to determine lung volumes using sensors,939.0,469.5,52.02,1277.04,32
CDM,8651046,Test to determine lung volumes using gas dilution or washout,666.0,333.0,55.36,905.76,32
CDM,8651047,Test to measure resistance of the airways and lungs to differing frequencies,506.0,253.0,52.02,688.16,32
CDM,8651048,Test to examine how well the lungs exchange gases,788.0,394.0,57.93,1071.68,32
CDM,8651056,Computer-assisted image-guided navigation of lung airways using an endoscope,2697.0,1348.5,809.1,3667.92,28
CDM,8651057,Dilation of windpipe cartilage or treatment of broken windpipe cartilage using an endoscope,6534.0,3267.0,1960.2,8886.24,32
CDM,8651058,Test for exercise-induced lung stress,650.0,325.0,72.29,884.0,32
CDM,8651059,Test for exercise-induced spasm of lung airways,600.0,300.0,72.29,816.0,32
CDM,8651061,"HB OLYMPUS SPIRATION VALVE SYSTEM, SIZE 5-7MM, HUD",7950.0,3975.0,1987.5,5247.0,16
CDM,8651063,"HB DEPLOYMENT CATHETER AND LOADER, HUD",3000.0,1500.0,750.0,1980.0,16
CDM,8681001,"Ultrasound of heart blood flow, valves and chambers, follow-up",810.0,405.0,88.84,1101.6,32
CDM,8681002,"Ultrasound of heart, follow-up",889.0,444.5,116.62,1209.04,32
CDM,8681004,"Ultrasound of heart blood flow, valves and chambers",1082.0,541.0,103.38,1471.52,32
CDM,8681007,Ultrasound of heart,1703.0,851.5,190.8,2316.08,32
CDM,8681008,"Ultrasound of heart with color-depicted blood flow, rate and valve function",960.0,480.0,65.17,1305.6,32
CDM,8681016,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1718.0,859.0,234.85,2336.48,32
CDM,8681018,"Ultrasound of heart with probe in esophagus, with report",3054.0,1527.0,343.57,4153.44,32
CDM,8681023,"Ultrasound of heart with probe in esophagus for congenital defect, with report",2573.0,1286.5,543.5,3499.28,32
CDM,8681049,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,5038.0,2519.0,543.5,6851.68,32
CDM,8681052,Heart muscle strain imaging,998.0,499.0,299.4,1357.28,32
CDM,8713822500,"Harvesting of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy, per day",3500.0,1750.0,1050.0,4760.0,26
CDM,8721002,Exercise or drug-induced heart stress test with electrocardiogram (ECG),1750.0,875.0,139.84,2380.0,32
CDM,8723822600,Preparation of blood-derived T white blood cells (T lymphocytes) for transportation for chimeric antigen receptor T-cell (CAR-T) therapy,1800.0,900.0,540.0,2448.0,26
CDM,8733822700,Receipt and preparation of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,1129.0,564.5,338.7,1535.44,26
CDM,8743822800,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,5809.0,2904.5,425.3,7900.24,26
CDM,8771002,Mechanical separation of white blood cells and platelets from blood,12376.0,6188.0,3712.8,16831.36,32
CDM,9061001,Hemodialysis procedure with physician evaluation,1685.0,842.5,505.5,2291.6,32
CDM,9061003,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,32
CDM,9061004,Hemodialysis procedure with physician evaluation,1685.0,842.5,505.5,2291.6,32
CDM,9061005,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,32
CDM,9067900,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",766.0,383.0,26.68,1041.76,32
CDM,9091001,Application of hot or cold packs,71.0,35.5,15.7,96.56,32
CDM,9091003,Removal of tissue from wound gradually,415.0,207.5,124.5,564.4,32
CDM,9091004,Application of electrical stimulation,101.0,50.5,21.31,137.36,32
CDM,9091005,"Therapy procedure for walking training, each 15 minutes",144.0,72.0,26.92,195.84,32
CDM,9091022,"Therapy procedure using massage, each 15 minutes",125.0,62.5,24.67,170.0,32
CDM,9091025,Therapy procedure in a group setting,148.0,74.0,18.04,201.28,32
CDM,9091026,Therapy procedure using functional activities,144.0,72.0,33.64,195.84,64
CDM,9091027,Application of mechanical traction,146.0,73.0,14.75,198.56,32
CDM,9091063,"Application of electrical stimulation with therapist present, each 15 minutes",139.0,69.5,14.75,189.04,32
CDM,9091071,"Removal of tissue from wound, 20.0 sq cm or less",623.0,311.5,186.9,847.28,32
CDM,9091072,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",144.0,72.0,31.39,195.84,32
CDM,9091073,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",129.0,64.5,29.54,175.44,32
CDM,9091075,"Evaluation for wheelchair, each 15 minutes",126.0,63.0,23.56,171.36,64
CDM,9091109,"Training for self-care or home management, each 15 minutes",144.0,72.0,32.85,195.84,32
CDM,9091115,"Evaluation for physical therapy, typically 20 minutes",366.0,183.0,100.75,497.76,32
CDM,9091116,"Evaluation for physical therapy, typically 30 minutes",443.0,221.5,100.75,602.48,32
CDM,9091117,"Evaluation for physical therapy, typically 45 minutes",487.0,243.5,100.75,662.32,32
CDM,9091118,"Re-evaluation for physical therapy, typically 20 minutes",235.0,117.5,69.31,319.6,32
CDM,9121025,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",129.0,64.5,29.54,175.44,32
CDM,9121040,Therapy procedure in a group setting,148.0,74.0,18.04,201.28,32
CDM,9121042,"Training for self-care or home management, each 15 minutes",144.0,72.0,32.85,195.84,32
CDM,9121080,Therapy procedure using functional activities,144.0,72.0,33.64,195.84,32
CDM,9121092,Application of whirlpool therapy,115.0,57.5,16.12,156.4,32
CDM,9121095,"Application of ultrasound, each 15 minutes",134.0,67.0,14.44,182.24,32
CDM,9121096,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",144.0,72.0,31.39,195.84,32
CDM,9121099,"Application of electrical stimulation with therapist present, each 15 minutes",139.0,69.5,14.75,189.04,32
CDM,9131009,"Application of ultrasound, each 15 minutes",134.0,67.0,14.44,182.24,32
CDM,9131016,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",157.0,78.5,32.52,213.52,32
CDM,9131017,"Training in the use of artificial arm and/or leg, each 15 minutes",156.0,78.0,41.43,212.16,32
CDM,9131026,"Test or measurement for functional capacity, each 15 minutes",161.0,80.5,34.17,218.96,32
CDM,9131040,"Application of vein wound compression bandages on lower leg, ankle, and foot",490.0,245.0,147.0,666.4,32
CDM,9141013,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",157.0,78.5,32.52,213.52,32
CDM,9141050,"Evaluation for occupational therapy, typically 30 minutes",366.0,183.0,103.4,497.76,32
CDM,9141051,"Evaluation for occupational therapy, typically 45 minutes",443.0,221.5,103.4,602.48,32
CDM,9141052,"Evaluation for occupational therapy, typically 1 hour",487.0,243.5,103.4,662.32,32
CDM,9141053,"Re-evaluation for occupational therapy, typically 30 minutes",235.0,117.5,70.5,319.6,32
CDM,9141055,"Follow-up training in the use of orthopedic device or artificial arm, leg and/or trunk, each 15 minutes",171.0,85.5,24.67,232.56,32
CDM,9141057,"Therapy procedure for a range of mental processes, initial 15 minutes",144.0,72.0,21.9,195.84,32
CDM,9141058,"Therapy procedure for a range of mental processes, each additional 15 minutes",138.0,69.0,21.25,187.68,32
CDM,9149079200,Psychiatric diagnostic evaluation with medical services,685.0,342.5,205.5,931.6,30
CDM,9151128,Removal of growths or polyps of large bowel by mechanical snare using an endoscope inserted through surgically created opening into large bowel to skin,4662.0,2331.0,1236.88,6340.32,32
CDM,9151157,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,2530.0,1265.0,759.0,3440.8,32
CDM,9151158,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK,4050.0,2025.0,1197.41,5508.0,32
CDM,9151159,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK,4034.0,2017.0,1197.41,5486.24,32
CDM,9151174,Balloon dilation of large bowel using a flexible endoscope,5068.0,2534.0,1236.88,6892.48,32
CDM,9151176,Other procedure on bile duct,4178.0,2089.0,1167.83,5682.08,32
CDM,9151177,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",303.0,151.5,90.9,412.08,28
CDM,9151181,Removal of foreign bodies from small bowel using an endoscope,6572.0,3286.0,1971.6,8937.92,32
CDM,9151182,Other procedure on pancreas,10237.0,5118.5,911.78,13922.32,32
CDM,9161001,Diagnostic exam of anus using an endoscope,1112.0,556.0,171.32,1512.32,32
CDM,9161003,Control of bleeding in esophagus using a flexible endoscope,7027.0,3513.5,1210.47,9556.72,32
CDM,9161009,Diagnostic exam of rectum and lower large bowel using an endoscope,5743.0,2871.5,1197.41,7810.48,32
CDM,9161010,Diagnostic exam of large bowel using a flexible endoscope,4777.0,2388.5,1197.41,6496.72,32
CDM,9161013,"Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",4749.0,2374.5,1167.83,6458.64,32
CDM,9161014,"Insertion of tube or tube in esophagus, stomach, and/or upper small bowel using a flexible endoscope",4900.0,2450.0,1210.47,6664.0,32
CDM,9161015,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",5271.0,2635.5,1210.47,7168.56,32
CDM,9161016,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7749.0,3874.5,1210.47,10538.64,32
CDM,9161019,Diagnostic exam of lower portion of large bowel using a flexible endoscope,4433.0,2216.5,1197.41,6028.88,32
CDM,9161028,Destruction of polyp or growth of large bowel using a flexible endoscope,6204.0,3102.0,1236.88,8437.44,32
CDM,9161029,Injection of dilated vein of stomach and/or esophagus using a flexible endoscope,4641.0,2320.5,1210.47,6311.76,32
CDM,9161047,Removal of polyps or growths of large bowel using an endoscope with mechanical snare,5848.0,2924.0,1236.88,7953.28,32
CDM,9161056,"Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",4228.0,2114.0,1167.83,5750.08,32
CDM,9161067,Biopsy of lower large bowel using a flexible endoscope,4567.0,2283.5,1197.41,6211.12,32
CDM,9161068,Removal of foreign bodies in lower portion of large bowel using a flexible endoscope,5227.0,2613.5,1236.88,7108.72,32
CDM,9161070,Removal of foreign bodies in large bowel using a flexible endoscope,5538.0,2769.0,1236.88,7531.68,32
CDM,9161071,Biopsy of large bowel using a flexible endoscope,4991.0,2495.5,1236.88,6787.76,32
CDM,9161072,Control of bleeding of upper large bowel using a flexible endoscope,6023.0,3011.5,1236.88,8191.28,32
CDM,9161073,Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery,5220.0,2610.0,1236.88,7099.2,32
CDM,9161074,Study of esophagus to assess movement,2488.0,1244.0,480.47,3383.68,32
CDM,9161080,Measurement of hydrogen in breath to test for stomach and bowel symptoms,1775.0,887.5,69.31,2414.0,32
CDM,9161090,Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope,4935.0,2467.5,1210.47,6711.6,32
CDM,9161091,Biopsy of small bowel (except ileum) using an endoscope,5458.0,2729.0,1210.47,7422.88,32
CDM,9161092,Destruction of polyp or growth of small bowel using an endoscope,8419.0,4209.5,1210.47,11449.84,32
CDM,9161095,Removal of small bowel polyps or growths using an endoscope with mechanical snare,7715.0,3857.5,2314.5,10492.4,32
CDM,9161097,Control of bleeding of first or second part of small bowel using an endoscope,8221.0,4110.5,2466.3,11180.56,32
CDM,9161098,Insertion of stent in large bowel using a flexible endoscope,9308.0,4654.0,2542.8,12658.88,32
CDM,9161103,Diagnostic exam of small bowel using an endoscope inserted through surgically created opening from small bowel to skin,4189.0,2094.5,1167.83,5697.04,32
CDM,9161104,Biopsy of small bowel using an endoscope inserted through surgically created opening from lower small bowel to skin,4178.0,2089.0,1167.83,5682.08,32
CDM,9161105,Diagnostic exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3312.0,1656.0,993.6,4504.32,32
CDM,9161106,Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3565.0,1782.5,1069.5,4848.4,32
CDM,9161108,Control of bleeding of lower large bowel using a flexible endoscope,4848.0,2424.0,1236.88,6593.28,32
CDM,9161109,"Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5788.0,2894.0,1210.47,7871.68,32
CDM,9161110,Insertion of tube into middle small bowel using an endoscope,4566.0,2283.0,1210.47,6209.76,32
CDM,9161112,Decompression of twisted or abnormally dilated lower large bowel using a flexible endoscope,4800.0,2400.0,1197.41,6528.0,32
CDM,9161113,Removal of polyps or growths of lower large bowel using a flexible endoscope with mechanical snare,4896.0,2448.0,1236.88,6658.56,32
CDM,9161114,Destruction of polyp or growth of lower large bowel using a flexible endoscope,5045.0,2522.5,1236.88,6861.2,32
CDM,9161115,Tying of dilated veins of stomach and/or esophagus using a flexible endoscope,5370.0,2685.0,1210.47,7303.2,32
CDM,9161116,Dilation of stomach outlet using a flexible endoscope,6070.0,3035.0,1210.47,8255.2,32
CDM,9161117,Diagnostic exam of surgically created pouch of small bowel using an endoscope,2979.0,1489.5,893.7,4051.44,32
CDM,9161120,Insertion of guide wire with dilation of esophagus using a flexible endoscope,5699.0,2849.5,1167.83,7750.64,32
CDM,9161121,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare",5861.0,2930.5,1210.47,7970.96,32
CDM,9161122,Diagnostic exam of esophagus using a flexible endoscope through mouth,2569.0,1284.5,770.7,3493.84,32
CDM,9161127,Imaging of digestive tract done from the inside of the digestive tract,4738.0,2369.0,488.25,6443.68,32
CDM,9161131,Balloon dilation of lower large bowel using a flexible endoscope,4613.0,2306.5,1236.88,6273.68,32
CDM,9161132,HB GASTRO/JEJUNOSTOMY TUBE L-P,107.0,53.5,26.75,70.62,16
CDM,9161133,Monitoring and recording of esophageal function through a capsule attached to the esophagus wall,2628.0,1314.0,488.25,3574.08,32
CDM,9161135,Ultrasound exam of large bowel using a flexible endoscope,5875.0,2937.5,1236.88,7990.0,32
CDM,9161136,Injection beneath lining of large bowel using a flexible endoscope,4920.0,2460.0,1236.88,6691.2,32
CDM,9161137,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using a flexible endoscope,6582.0,3291.0,1540.78,8951.52,32
CDM,9161139,"Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5190.0,2595.0,1167.83,7058.4,32
CDM,9161140,Monitoring and recording of esophageal function through nasal tube,2395.0,1197.5,480.47,3257.2,32
CDM,9161147,Review by radiologist of image from tube placement into pancreatic duct using an endoscope,748.0,374.0,197.36,1017.28,32
CDM,9161148,Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope,1081.0,540.5,197.36,1470.16,32
CDM,9161149,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2955.0,1477.5,886.5,4018.8,32
CDM,9161150,Removal of external hemorrhoids by rubber banding,2599.0,1299.5,779.7,3534.64,32
CDM,9161168,Dilation of esophagus with insertion of guide wire using a flexible endoscope,9635.0,4817.5,1210.47,13103.6,32
CDM,9161171,Destruction of growth or polyp of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,4997.0,2498.5,1236.88,6795.92,32
CDM,9161184,Other procedure on stomach,4180.0,2090.0,1167.83,5684.8,32
CDM,9161186,Biopsy of small bowel pouch using an endoscope,4635.0,2317.5,1197.41,6303.6,32
CDM,9161196,Placement of stent in esophagus using a flexible endoscope,7841.0,3920.5,2352.3,10663.76,32
CDM,9161199,Destruction of polyp or growth of esophagus using a flexible endoscope,7500.0,3750.0,2250.0,10200.0,32
CDM,9161200,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more",6461.0,3230.5,1210.47,8786.96,32
CDM,9161201,"Injection of diagnostic or therapeutic substance or marker in esophagus, stomach, and/or upper small bowel using a flexible endoscope",5262.0,2631.0,1210.47,7156.32,32
CDM,9161202,"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5381.0,2690.5,1614.3,7318.16,32
CDM,9161203,"Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope",11723.0,5861.5,3516.9,15943.28,32
CDM,9161204,"Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7703.0,3851.5,2310.9,10476.08,32
CDM,9161205,Insertion of stent into pancreatic or bile duct using a flexible endoscope,10216.0,5108.0,3064.8,13893.76,32
CDM,9161206,Removal of stent from pancreatic or bile duct using a flexible endoscope,9200.0,4600.0,2470.77,12512.0,32
CDM,9161207,Replacement of stent in pancreatic or bile duct using a flexible endoscope,11755.0,5877.5,3526.5,15986.8,32
CDM,9161208,Balloon dilation of pancreatic or bile duct or sphincter using a flexible endoscope,9249.0,4624.5,2774.7,12578.64,32
CDM,9161209,Destruction of polyp or growth of gallbladder and/or bile duct using a flexible endoscope,10577.0,5288.5,3173.1,14384.72,32
CDM,9161210,Other procedure on small bowel,5205.0,2602.5,1167.83,7078.8,32
CDM,9161212,Biopsy of small bowel using an endoscope,6634.0,3317.0,1210.47,9022.24,32
CDM,9161214,Removal of defect in wall of esophagus using a rigid endoscope,10175.0,5087.5,3052.5,13838.0,32
CDM,9161215,Balloon dilation of small bowel using an endoscope,3998.0,1999.0,1199.4,5437.28,32
CDM,9161218,Injection beneath lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3565.0,1782.5,1069.5,4848.4,32
CDM,9161223,Removal of lower portion of large bowel tissue using a flexible endoscope,5146.0,2573.0,1543.8,6998.56,32
CDM,9161224,Banding of hemorrhoids using a flexible endoscope (sigmoidoscope),4705.0,2352.5,1236.88,6398.8,32
CDM,9161225,Removal of large bowel tissue using a flexible endoscope,6779.0,3389.5,2033.7,9219.44,32
CDM,9161226,Decompression of twisted or abnormally dilated large bowel using a flexible endoscope,5704.0,2852.0,1236.88,7757.44,32
CDM,9161227,Banding of hemorrhoids using a flexible endoscope (colonoscope),5376.0,2688.0,1236.88,7311.36,32
CDM,9161228,Other procedure on large bowel,3435.0,1717.5,1030.5,4671.6,32
CDM,9161235,Incision of muscle of lower esophagus using an endoscope,10730.0,5365.0,3219.0,14592.8,32
CDM,9161237,Repair of muscle at esophagus and stomach using a flexible endoscope,15196.0,7598.0,4558.8,20666.56,32
CDM,9161241,"Needle biopsy of lobe of lung using an endoscope, each additional lobe",2570.0,1285.0,771.0,3495.2,32
CDM,9161242,Insertion of peripheral nerve neurostimulator electrode through skin,19256.0,9628.0,5776.8,26188.16,32
CDM,9171105,Review by radiologist of CT guidance for needle placement,2864.0,1432.0,103.38,3895.04,32
CDM,9171112,CT scan head or brain without contrast,1803.0,901.5,134.61,2452.08,32
CDM,9171642,CT scan of cranial cavity with contrast,2561.0,1280.5,225.85,3482.96,32
CDM,9171643,CT scan of cranial cavity before and after contrast,2831.0,1415.5,225.85,3850.16,32
CDM,9171644,CT scan of face with contrast,2202.0,1101.0,225.85,2994.72,32
CDM,9171645,CT scan of soft tissue of neck with contrast,2625.0,1312.5,225.85,3570.0,32
CDM,9171646,CT scan of chest with contrast,2668.0,1334.0,225.85,3628.48,32
CDM,9171647,CT scan of upper spine with contrast,2806.0,1403.0,381.53,3816.16,32
CDM,9171648,CT scan of middle spine without contrast,2177.0,1088.5,133.94,2960.72,32
CDM,9171649,CT scan of middle spine with contrast,2592.0,1296.0,225.85,3525.12,32
CDM,9171650,CT scan of middle spine before and after contrast,3127.0,1563.5,225.85,4252.72,32
CDM,9171651,CT scan of lower spine without contrast,2351.0,1175.5,133.94,3197.36,32
CDM,9171652,CT scan of lower spine with contrast,2666.0,1333.0,381.53,3625.76,32
CDM,9171653,CT scan of lower spine before and after contrast,2868.0,1434.0,225.85,3900.48,32
CDM,9171654,CT scan of pelvis with contrast,2814.0,1407.0,225.85,3827.04,32
CDM,9171656,CT scan of arm before and after contrast,3269.0,1634.5,225.85,4445.84,32
CDM,9171657,CT scan of leg without contrast,2187.0,1093.5,133.94,2974.32,32
CDM,9171658,CT scan of leg with contrast material,2489.0,1244.5,225.85,3385.04,32
CDM,9171659,CT scan of leg before and after contrast,2990.0,1495.0,225.85,4066.4,32
CDM,9171660,CT scan of abdomen with contrast,2749.0,1374.5,225.85,3738.64,32
CDM,9173063,CT scan head or brain with contrast,2484.0,1242.0,225.85,3378.24,32
CDM,9173064,CT scan of head or brain before and after contrast,2959.0,1479.5,225.85,4024.24,32
CDM,9173065,CT scan of cranial cavity without contrast,2148.0,1074.0,133.94,2921.28,32
CDM,9173066,CT scan of face without contrast,1983.0,991.5,133.94,2696.88,32
CDM,9173067,CT scan of face before and after contrast,2742.0,1371.0,225.85,3729.12,32
CDM,9173068,CT scan of soft tissue of neck without contrast,2300.0,1150.0,133.94,3128.0,32
CDM,9173069,CT scan of soft tissue of neck before and after contrast,2975.0,1487.5,225.85,4046.0,32
CDM,9173070,CT scan of chest without contrast,2012.0,1006.0,133.94,2736.32,32
CDM,9173071,CT scan of chest before and after contrast,3168.0,1584.0,225.85,4308.48,32
CDM,9173072,CT scan of upper spine without contrast,2449.0,1224.5,133.94,3330.64,32
CDM,9173073,CT scan of upper spine before and after contrast,3133.0,1566.5,225.85,4260.88,32
CDM,9173075,CT scan of pelvis without contrast,2058.0,1029.0,133.94,2798.88,32
CDM,9173076,CT scan of pelvis before and after contrast,3655.0,1827.5,225.85,4970.8,32
CDM,9173077,CT scan of arm without contrast,1939.0,969.5,133.94,2637.04,32
CDM,9173078,CT scan of abdomen without contrast,2065.0,1032.5,133.94,2808.4,32
CDM,9173079,CT scan of abdomen before and after contrast,3209.0,1604.5,225.85,4364.24,32
CDM,9173306,CT scan of blood vessels of head with contrast,3047.0,1523.5,225.85,4143.92,32
CDM,9173307,CT scan of blood vessels of neck with contrast,3131.0,1565.5,225.85,4258.16,32
CDM,9173308,CT scan of blood vessels of chest with contrast,3365.0,1682.5,225.85,4576.4,32
CDM,9173309,CT scan of blood vessels of pelvis with contrast,3489.0,1744.5,225.85,4745.04,32
CDM,9173312,CT scan of blood vessels of abdomen with contrast,4319.0,2159.5,225.85,5873.84,32
CDM,9173313,CT scan of abdominal aorta and both leg arteries with contrast,3247.0,1623.5,225.85,4415.92,32
CDM,9173439,CT guidance for tissue removal,3081.0,1540.5,103.38,4190.16,32
CDM,9173456,Destruction of growths and adjacent soft tissue,20119.0,10059.5,2246.0,27361.84,32
CDM,9173462,3D radiographic procedure,608.0,304.0,182.4,826.88,28
CDM,9173476,CT scan of blood vessels of lower leg with contrast,3364.0,1682.0,225.85,4575.04,32
CDM,9173477,CT scan of arm with contrast,2444.0,1222.0,368.92,3323.84,32
CDM,9173482,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",10.0,5.0,0.25,13.6,28
CDM,9173483,Limited or follow-up CT scan,1074.0,537.0,112.05,1460.64,32
CDM,9173484,CT scan of blood vessels of arm with contrast,3336.0,1668.0,225.85,4536.96,32
CDM,9173485,Diagnostic CT scan of large intestine without contrast,1311.0,655.5,133.94,1782.96,32
CDM,9173486,Diagnostic CT scan of large intestine with contrast,1249.0,624.5,225.85,1698.64,32
CDM,9173487,Screening CT scan of large intestine,1436.0,718.0,133.94,1952.96,32
CDM,9173488,CT scan of heart with evaluation of blood vessel calcium,1135.0,567.5,112.05,1543.6,32
CDM,9173489,CT scan of heart structure with contrast,1855.0,927.5,381.53,2522.8,32
CDM,9173490,CT scan of congenital heart disease with contrast,1770.0,885.0,381.53,2407.2,32
CDM,9173491,CT scan of blood vessels and grafts of heart with contrast,3036.0,1518.0,449.2,4128.96,32
CDM,9173492,CT scan of abdomen and pelvis without contrast,5799.0,2899.5,307.22,7886.64,32
CDM,9173493,CT scan of abdomen and pelvis with contrast,6486.0,3243.0,381.53,8820.96,32
CDM,9173494,CT scan of abdomen and pelvis before and after contrast,8162.0,4081.0,381.53,11100.32,32
CDM,9173499,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1425.0,712.5,427.5,1938.0,32
CDM,9173501,CT scan of blood vessels of abdomen and pelvis with contrast,5024.0,2512.0,425.0,6832.64,32
CDM,9173503,Low dose CT scan of chest for lung cancer screening,2681.0,1340.5,133.94,3646.16,32
CDM,9181013,"Pathology examination of tissue using a microscope, moderately high complexity",1167.0,583.5,165.12,1587.12,32
CDM,9191260,MRI scan of brain without contrast,2553.0,1276.5,302.84,3472.08,32
CDM,9191261,MRI scan of brain with contrast,2670.0,1335.0,449.2,3631.2,32
CDM,9191263,MRI scan of brain before and after contrast,4781.0,2390.5,449.2,6502.16,32
CDM,9191266,MRI scan of upper spinal canal without contrast,3150.0,1575.0,302.84,4284.0,32
CDM,9191267,MRI scan of upper spinal canal with contrast,3721.0,1860.5,449.2,5060.56,32
CDM,9191268,MRI scan of upper spinal canal before and after contrast,4538.0,2269.0,449.2,6171.68,32
CDM,9191272,MRI scan of chest without contrast,2857.0,1428.5,302.84,3885.52,32
CDM,9191281,MRI scan of lower spinal canal without contrast,3225.0,1612.5,302.84,4386.0,32
CDM,9191282,MRI scan of lower spinal canal before and after contrast,4718.0,2359.0,449.2,6416.48,32
CDM,9191287,"MRI scan of bone of eye socket, face, and/or neck without contrast",2238.0,1119.0,302.84,3043.68,32
CDM,9191687,MRI scan of middle spinal canal without contrast,3286.0,1643.0,302.84,4468.96,32
CDM,9191688,MRI scan of middle spinal canal with contrast,4238.0,2119.0,449.2,5763.68,32
CDM,9191689,MRI scan of middle spinal canal before and after contrast,4538.0,2269.0,449.2,6171.68,32
CDM,9191690,MRI scan of blood vessels of spinal canal,4765.0,2382.5,617.13,6480.4,32
CDM,9191691,MRI scan of arm before and after contrast,4481.0,2240.5,449.2,6094.16,32
CDM,9191692,MRI scan of arm joint without contrast,2577.0,1288.5,302.84,3504.72,32
CDM,9191693,MRI scan of leg before and after contrast,4166.0,2083.0,449.2,5665.76,32
CDM,9191694,MRI scan of leg joint without contrast,2594.0,1297.0,302.84,3527.84,32
CDM,9191695,MRI scan of abdomen without contrast,3090.0,1545.0,302.84,4202.4,32
CDM,9191696,MRI scan of blood vessels of spinal canal,3907.0,1953.5,617.13,5313.52,32
CDM,9191697,MRI scan of blood vessels of spinal canal,3308.0,1654.0,617.13,4498.88,32
CDM,9191701,Functional MRI scan of brain with neurofunctional testing,2543.0,1271.5,302.84,3458.48,32
CDM,9193074,MRI scan of lower spinal canal with contrast,3545.0,1772.5,449.2,4821.2,32
CDM,9193218,MRI study for measuring biochemical changes in the brain,1936.0,968.0,112.05,2632.96,32
CDM,9193314,"MRI scan of bone of eye socket, face, and/or neck with contrast",3122.0,1561.0,449.2,4245.92,32
CDM,9193315,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",3953.0,1976.5,449.2,5376.08,32
CDM,9193316,MRI scan of blood vessels of head without contrast,2486.0,1243.0,307.22,3380.96,32
CDM,9193317,MRI scan of blood vessels of head with contrast,2530.0,1265.0,449.2,3440.8,32
CDM,9193318,MRI scan of blood vessels of head before and after contrast,3850.0,1925.0,449.2,5236.0,32
CDM,9193319,MRI scan of blood vessels of neck without contrast,2503.0,1251.5,307.22,3404.08,32
CDM,9193320,MRI scan of blood vessels of neck with contrast,2801.0,1400.5,449.2,3809.36,32
CDM,9193321,MRI scan of blood vessels of neck before and after contrast,3214.0,1607.0,449.2,4371.04,32
CDM,9193323,MRI scan of chest before and after contrast,5295.0,2647.5,449.2,7201.2,32
CDM,9193324,MRI scan of pelvis without contrast,3205.0,1602.5,302.84,4358.8,32
CDM,9193325,MRI scan of pelvis before and after contrast,3930.0,1965.0,449.2,5344.8,32
CDM,9193326,MRI scan of arm without contrast,2185.0,1092.5,302.84,2971.6,32
CDM,9193329,MRI scan of arm joint before and after contrast,4797.0,2398.5,449.2,6523.92,32
CDM,9193330,MRI scan of leg without contrast,2824.0,1412.0,302.84,3840.64,32
CDM,9193332,MRI scan of leg joint with contrast,3715.0,1857.5,510.96,5052.4,32
CDM,9193333,MRI scan of leg joint before and after contrast,4238.0,2119.0,449.2,5763.68,32
CDM,9193335,MRI scan of abdomen before and after contrast,4285.0,2142.5,449.2,5827.6,32
CDM,9193336,Review by radiologist of MRI guidance for needle placement,2763.0,1381.5,273.73,3757.68,32
CDM,9193448,MRI scan of blood vessels of abdomen,4034.0,2017.0,617.13,5486.24,32
CDM,9193449,MRI scan of blood vessels of abdomen,3245.0,1622.5,617.13,4413.2,32
CDM,9193450,MRI scan of blood vessels of abdomen,4499.0,2249.5,617.13,6118.64,32
CDM,9193451,MRI scan of blood vessels of chest,3000.0,1500.0,617.13,4080.0,32
CDM,9193452,MRI scan of blood vessels of chest,4948.0,2474.0,617.13,6729.28,32
CDM,9193453,MRI scan of blood vessels of chest,5560.0,2780.0,617.13,7561.6,32
CDM,9193454,MRI scan of blood vessels of pelvis,4016.0,2008.0,617.13,5461.76,32
CDM,9193455,MRI scan of blood vessels of pelvis,3365.0,1682.5,617.13,4576.4,32
CDM,9193456,MRI scan of blood vessels of pelvis,4127.0,2063.5,617.13,5612.72,32
CDM,9193457,MRI scan of blood vessels of leg,3901.0,1950.5,617.13,5305.36,32
CDM,9193458,MRI scan of blood vessels of leg,2724.0,1362.0,617.13,3704.64,32
CDM,9193459,MRI scan of blood vessels of leg,4450.0,2225.0,617.13,6052.0,32
CDM,9193461,MRI scan of blood vessels of arm,5037.0,2518.5,617.13,6850.32,32
CDM,9193464,MRI scan of arm joint with contrast,4025.0,2012.5,510.96,5474.0,32
CDM,9193465,MRI scan of heart without contrast,2560.0,1280.0,302.84,3481.6,32
CDM,9193469,MRI scan of heart before and after contrast,4134.0,2067.0,449.2,5622.24,32
CDM,9193471,MRI scan of heart before and after contrast with stress imaging,4749.0,2374.5,510.96,6458.64,32
CDM,9193474,MRI scan of chest with contrast,4712.0,2356.0,510.96,6408.32,32
CDM,9193477,MRI scan of blood flow of heart,4078.0,2039.0,302.84,5546.08,32
CDM,9193478,MRI scan of blood vessels of arm,4226.0,2113.0,617.13,5747.36,32
CDM,9193479,MRI scan of blood vessels of arm,2706.0,1353.0,617.13,3680.16,32
CDM,9193480,MRI scan of jaw joint,3026.0,1513.0,302.84,4115.36,32
CDM,9193487,MRI scan of fetus for single or first pregnancy,3002.0,1501.0,302.84,4082.72,32
CDM,9193490,MRI and low frequency vibrations for measuring tissue stiffness,2185.0,1092.5,302.84,2971.6,32
CDM,9193491,MRI scan of 1 breast without contrast,2160.0,1080.0,302.84,2937.6,32
CDM,9193492,MRI scan of 1 breast,3379.0,1689.5,510.96,4595.44,32
CDM,9193493,MRI scan of both breasts without contrast,3332.0,1666.0,302.84,4531.52,32
CDM,9193494,MRI scan of both breasts,4500.0,2250.0,510.96,6120.0,32
CDM,9200000,Measurement of lymphedema extracellular fluid,464.0,232.0,77.51,631.04,32
CDM,9201404,Limited ultrasound scan of abdomen,1063.0,531.5,89.71,1445.68,32
CDM,9201407,Ultrasonic guidance for needle placement,1398.0,699.0,95.32,1901.28,32
CDM,9201427,Ultrasonic guidance during surgery,1524.0,762.0,141.06,2072.64,32
CDM,9201441,Ultrasound scan of head and neck soft tissue,1238.0,619.0,88.59,1683.68,32
CDM,9201444,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",1028.0,514.0,95.32,1398.08,32
CDM,9201869,Limited ultrasound of pregnant uterus,821.0,410.5,88.59,1116.56,32
CDM,9201870,Follow-up ultrasound scan of pregnant uterus,818.0,409.0,69.52,1112.48,32
CDM,9201872,Ultrasound scan of fetal heart,1464.0,732.0,123.35,1991.04,32
CDM,9201878,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,853.0,426.5,255.9,1160.08,32
CDM,9201879,Ultrasound scan of infant hip during movement,801.0,400.5,112.05,1089.36,32
CDM,9201898,Removal of sample of amniotic fluid surrounding fetus for diagnosis,1728.0,864.0,518.4,2350.08,32
CDM,9201899,Aspiration of fluid from chest cavity,1686.0,843.0,505.8,2292.96,32
CDM,9201900,Aspiration of fluid from chest cavity using imaging guidance,2219.0,1109.5,665.7,3017.84,32
CDM,9201901,Drainage of fluid from chest cavity with insertion of indwelling tube,2966.0,1483.0,889.8,4033.76,32
CDM,9203467,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",850.0,425.0,126.37,1156.0,32
CDM,9205902000,Fetal contraction stress test,641.0,320.5,192.3,871.76,32
CDM,9205902500,Fetal test,975.0,487.5,242.91,1326.0,32
CDM,9209213700,Imaging of retina with optical coherence tomography angiography,934.0,467.0,278.02,1270.24,28
CDM,9209389600,Ultrasound of blood flow withing brain to assess flexibility of vessels,792.0,396.0,237.6,1077.12,28
CDM,9221035,Review by radiologist of pelvis artery image,8453.0,4226.5,194.18,11496.08,32
CDM,9221036,Review by radiologist of arteries of both lungs image,5089.0,2544.5,163.03,6921.04,32
CDM,9221133,Review by radiologist of additional artery image,2139.0,1069.5,641.7,5880.39,32
CDM,9221195,Review by radiologist of image from tube placement into bile duct using an endoscope,887.0,443.5,197.36,1206.32,32
CDM,9221218,Review by radiologist of liver vein image with assessment of blood flow,4971.0,2485.5,163.68,6760.56,32
CDM,9221354,Review by radiologist of the vein that transports blood to the liver image,4922.0,2461.0,164.34,6693.92,32
CDM,9221391,Review by radiologist of the vein that transports blood to the liver image with assessment of blood flow,4971.0,2485.5,163.03,6760.56,32
CDM,9221452,Review by radiologist of major upper body vein image,3499.0,1749.5,151.34,4758.64,32
CDM,9221453,Review by radiologist of liver vein image,4922.0,2461.0,164.34,6693.92,32
CDM,9221454,Review by radiologist of kidney image,4922.0,2461.0,157.19,6693.92,32
CDM,9221455,Review by radiologist of head or neck vein system image,4922.0,2461.0,160.44,6693.92,32
CDM,9221456,Review by radiologist of imaging guidance for removal of blood sample,8453.0,4226.5,168.23,11496.08,32
CDM,9221472,Review by radiologist of lung artery image with contrast,4922.0,2461.0,176.65,6693.92,32
CDM,9221474,Review by radiologist of chest aorta serial images,8453.0,4226.5,151.99,11496.08,32
CDM,9221475,Review by radiologist of abdominal aorta image,4922.0,2461.0,151.34,6693.92,32
CDM,9221477,Review by radiologist of image for insertion of material to block blood flow,5605.0,2802.5,253.72,7622.8,32
CDM,9221486,Fluoroscopic guidance for needle placement,1361.0,680.5,81.86,1850.96,32
CDM,9221501,Review by radiologist of bile and/or pancreatic duct image during surgery,804.0,402.0,22.42,1093.44,32
CDM,9221518,Insertion of tube for infusion (5 years or older),2726.0,1363.0,817.8,3707.36,32
CDM,9221601,Review by radiologist of major lower body vein image,4922.0,2461.0,146.79,6693.92,32
CDM,9221602,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,2429.0,1214.5,59.43,3303.44,32
CDM,9221603,Review by radiologist of both arms and legs veins of both arms or legs image,2708.0,1354.0,91.95,3682.88,32
CDM,9221661,Review by radiologist of image for drainage of fluid,2322.0,1161.0,196.23,3157.92,32
CDM,9221662,Removal of fluid from between lung and chest cavity,2672.0,1336.0,801.6,3633.92,32
CDM,9221672,Needle biopsy of muscle,3438.0,1719.0,857.07,4675.68,32
CDM,9221673,Biopsy of bone using needle or trocar,2786.0,1393.0,835.8,3788.96,32
CDM,9221674,Deep biopsy of bone using needle or trocar,3985.0,1992.5,1195.5,5419.6,32
CDM,9221675,Needle biopsy of lining of lung,3183.0,1591.5,954.9,4328.88,32
CDM,9221677,Needle biopsy of liver through skin,3751.0,1875.5,905.56,5101.36,32
CDM,9221679,Needle biopsy of growth of abdominal cavity,4588.0,2294.0,905.56,6239.68,32
CDM,9221680,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,1821.0,910.5,546.3,2476.56,32
CDM,9221682,"Aspiration of cyst of breast, first cyst",1523.0,761.5,456.9,2071.28,32
CDM,9221684,Aspiration and/or injection of cyst of kidney,3972.0,1986.0,506.45,5401.92,32
CDM,9221713,Injection for X-ray imaging procedure into vein of arm or leg,843.0,421.5,252.9,1146.48,32
CDM,9221714,Insertion of tube into vena cava,2725.0,1362.5,817.5,3706.0,32
CDM,9221715,"Insertion of tube into vein, first order branch",2265.0,1132.5,679.5,3080.4,32
CDM,9221716,"Insertion of tube into vein, second order branch",2750.0,1375.0,825.0,3740.0,32
CDM,9221717,Insertion of tube into right heart or main pulmonary artery,1018.0,509.0,305.4,1384.48,32
CDM,9221720,Insertion of needle or tube into artery of arm or leg,1956.0,978.0,586.8,2660.16,32
CDM,9221723,Insertion of tube into aorta,2063.0,1031.5,618.9,2805.68,32
CDM,9221727,Insertion of needle into vein (3 years or older),172.0,86.0,10.99,233.92,32
CDM,9221730,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",3199.0,1599.5,858.24,4350.64,32
CDM,9221731,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",1513.0,756.5,453.9,2057.68,32
CDM,9221732,"Insertion of tube into chest or arm artery, each first order branch",2091.0,1045.5,627.3,2843.76,32
CDM,9221733,"Insertion of tube into chest or arm artery, initial second order branch",2605.0,1302.5,781.5,3542.8,32
CDM,9221734,"Insertion of tube into chest or arm artery, initial third order branch",3562.0,1781.0,858.24,4844.32,32
CDM,9221735,"Insertion of tube into chest or arm artery, additional second, third order and beyond",1513.0,756.5,453.9,2057.68,32
CDM,9221736,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",3541.0,1770.5,858.24,4815.76,32
CDM,9221737,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",4355.0,2177.5,858.24,5922.8,32
CDM,9221738,"Biopsy of gallbladder, pancreatic, liver, and bile ducts using a flexible endoscope",8819.0,4409.5,2645.7,11993.84,32
CDM,9221739,Incision of pancreatic outlet using a flexible endoscope,8727.0,4363.5,2618.1,11868.72,32
CDM,9221741,Removal of stone or debris from bile or pancreatic duct using a flexible endoscope,8909.0,4454.5,2672.7,12116.24,32
CDM,9221742,Destruction of stone of bile or pancreatic duct using a flexible endoscope,10560.0,5280.0,3168.0,14361.6,32
CDM,9221749,Repositioning of oral or nasal feeding tube in small bowel,1975.0,987.5,321.7,2686.0,32
CDM,9221750,Insertion of stomach tube using a flexible endoscope,6432.0,3216.0,1210.47,8747.52,32
CDM,9221753,Conversion of stomach tube to tube in middle small bowel using an endoscope,6619.0,3309.5,1210.47,9001.84,32
CDM,9221756,"Balloon dilation of esophagus using a flexible endoscope, less than 3.0 cm",4802.0,2401.0,1210.47,6530.72,32
CDM,9221765,Injection of bladder and ureter for imaging,1549.0,774.5,411.09,2106.64,32
CDM,9221773,Injection procedure through bladder and urethra for X-ray imaging,1591.0,795.5,411.09,2163.76,32
CDM,9221779,Injection of contrast for imaging of lower spinal canal,1142.0,571.0,342.6,1553.12,32
CDM,9221782,Review by radiologist of disc of lower spine image,4028.0,2014.0,100.66,5478.08,32
CDM,9221783,Injection of contrast for imaging of each level of lower spine,1950.0,975.0,411.09,2652.0,32
CDM,9221785,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",6058.0,3029.0,1167.83,8238.88,32
CDM,9221789,"Diagnostic exam of gallbladder and pancreatic, liver, and bile ducts using an endoscope",7889.0,3944.5,2366.7,10729.04,32
CDM,9221792,Review by radiologist of abdominal artery image,8453.0,4226.5,172.78,11496.08,32
CDM,9221795,Review by radiologist of lung artery image,4922.0,2461.0,161.09,6693.92,32
CDM,9221796,Insertion of tube into left or right pulmonary artery,2966.0,1483.0,858.24,4033.76,32
CDM,9221797,Insertion of tube into artery of lobe of lung,2243.0,1121.5,672.9,3050.48,32
CDM,9221798,Review by radiologist of breast artery of breast image,4922.0,2461.0,204.58,6693.92,32
CDM,9221805,Review by radiologist of lymphatic system of side of pelvis and abdomen image,3344.0,1672.0,380.13,4547.84,32
CDM,9221811,Insertion of tube into portal vein of liver,2426.0,1213.0,727.8,3299.36,32
CDM,9221813,Imaging of blood vessel,4922.0,2461.0,66.16,6693.92,32
CDM,9221814,Insertion of tube into vein with collection of blood sample,1018.0,509.0,305.4,1384.48,32
CDM,9221820,Review by radiologist of image from placement of uterine tube,819.0,409.5,196.23,1113.84,32
CDM,9221821,Insertion of tube into fallopian tube,4972.0,2486.0,1491.6,6761.92,32
CDM,9221822,Review by radiologist of abdominal aorta and both leg arteries image,4922.0,2461.0,151.34,6693.92,32
CDM,9221843,Biopsy of blood vessel using tube,8453.0,4226.5,2535.9,11496.08,32
CDM,9221848,Insertion of tube into gallbladder using imaging guidance with review by radiologist,5799.0,2899.5,1739.7,7886.64,32
CDM,9221892,Needle biopsy or removal of surface lymph nodes,2786.0,1393.0,835.8,3788.96,32
CDM,9221893,Needle biopsy of kidney,3890.0,1945.0,1167.0,5290.4,32
CDM,9221894,Needle biopsy of thyroid through skin,2196.0,1098.0,658.8,2986.56,32
CDM,9221913,Review by radiologist of previous placed shunt image,645.0,322.5,49.33,877.2,32
CDM,9221915,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,1814.0,907.0,500.68,2467.04,32
CDM,9221983,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,32
CDM,9221984,Aspiration of bladder with insertion of bladder tube to skin,4392.0,2196.0,1317.6,5973.12,32
CDM,9221991,"Aspiration of abscess, blood, or cyst",925.0,462.5,207.21,1258.0,32
CDM,9221994,"Aspiration of cyst of breast, each additional cyst",989.0,494.5,296.7,1345.04,32
CDM,9223003,Removal of cerebrospinal fluid with lower back spinal tap,1870.0,935.0,561.0,2543.2,32
CDM,9223038,Review by radiologist of image for biopsy of blood vessel with tube,3119.0,1559.5,253.72,4241.84,32
CDM,9223041,Removal of foreign bodies in esophagus using a flexible endoscope,3761.0,1880.5,1128.3,5114.96,32
CDM,9223062,Occlusion of head or neck artery,28259.0,14129.5,8477.7,38432.24,32
CDM,9223080,Review by radiologist of arm or leg artery image,4922.0,2461.0,197.44,6693.92,32
CDM,9223081,Review by radiologist of both arms or legs arteries image,5456.0,2728.0,227.29,7420.16,32
CDM,9223083,Review by radiologist of image for replacement of stomach or large bowel tube,1263.0,631.5,122.23,1717.68,32
CDM,9223098,Exchange of abdominal cavity drainage tube using imaging guidance,4386.0,2193.0,905.56,5964.96,32
CDM,9223099,Injection of contrast through abdominal cavity tube for X-ray study,1127.0,563.5,338.1,1532.72,32
CDM,9223104,Artery puncture collection of blood sample,150.0,75.0,45.0,204.0,32
CDM,9223109,Simple or single drainage of skin abscess,1096.0,548.0,207.21,1490.56,32
CDM,9223110,Complicated or multiple drainage of skin abscess,1403.0,701.5,207.21,1908.08,32
CDM,9223111,Drainage of blood or fluid accumulation,4113.0,2056.5,1233.9,5593.68,32
CDM,9223115,HB COSMETIC CONSULTATION LEVEL 1,60.0,30.0,18.0,36.0,2
CDM,9223120,"HB COSMETIC SURGERY (MILI,LENT,SEB)",40.0,20.0,12.0,24.0,2
CDM,9223122,HB COSMETIC SURGERY (DPN),54.0,27.0,16.2,32.4,2
CDM,9223123,"HB COSMETIC SURGEY (DPN,MOLE)",120.0,60.0,36.0,72.0,2
CDM,9223124,"HB COSEMETIC (DPN,MOLE)-CS4",140.0,70.0,42.0,84.0,2
CDM,9223132,Injection of chemical agent into single incompetent vein,625.0,312.5,187.5,850.0,32
CDM,9223133,Injection of chemical agent into multiple incompetent veins of leg,688.0,344.0,206.4,935.68,32
CDM,9223147,HB HAIR REMOVAL LASER LIP,60.0,30.0,18.0,36.0,2
CDM,9223149,HB HAIR REMOVAL LASER CHIN,70.0,35.0,21.0,42.0,2
CDM,9223150,HB HAIR REMOVAL LASER LIP & CHIN,100.0,50.0,30.0,60.0,2
CDM,9223151,HB HAIR REMOVAL LASER FACE & BEARD,140.0,70.0,42.0,84.0,2
CDM,9223152,HB HAIR REMOVAL LASER UNDERARMS,140.0,70.0,42.0,84.0,2
CDM,9223159,HB JUVULTXCPLUS,420.0,210.0,126.0,252.0,2
CDM,9223165,HB KYBELLA - ONE BOTTLE,390.0,195.0,117.0,234.0,2
CDM,9223171,"HB COSMETIC LESION, KELOID, MOLE RMVL LRG",280.0,140.0,84.0,168.0,2
CDM,9223173,HB LYFTLFT,480.0,240.0,144.0,288.0,2
CDM,9223212,Fluoroscopic guidance for spine or back muscle injection,967.0,483.5,83.59,1315.12,32
CDM,9223225,HB REST1,360.0,180.0,108.0,216.0,2
CDM,9223230,HB SCAR REVISION SMALL COMPLEX,300.0,150.0,90.0,180.0,2
CDM,9223231,HB SCAR REVISION LARGE SIMPLE,400.0,200.0,120.0,240.0,2
CDM,9223239,HB SEBORRHEIC KERATOSIS FIRST 5,80.0,40.0,24.0,48.0,2
CDM,9223240,HB SEBORRHEIC KERATOSIS EACH ADDITIONAL 5,100.0,50.0,30.0,60.0,2
CDM,9223301,HB SKIN TAGS FIRST 5,80.0,40.0,24.0,48.0,2
CDM,9223302,HB SKIN TAGS EACH ADDITIONAL 5,80.0,40.0,24.0,48.0,2
CDM,9223319,HB UNSPEC PROC LEVEL 3,480.0,240.0,144.0,288.0,2
CDM,9223327,HB VI PEEL,160.0,80.0,48.0,96.0,2
CDM,9223328,HB VI PEEL WITH BOOSTER,140.0,70.0,42.0,84.0,2
CDM,9223343,Collection of blood sample from implanted device,402.0,201.0,94.28,546.72,32
CDM,9223347,"Drainage of fluid collection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",9308.0,4654.0,2792.4,12658.88,32
CDM,9223348,"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7985.0,3992.5,1210.47,10859.6,32
CDM,9223350,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,778.0,389.0,233.4,1058.08,32
CDM,9223356,Insertion of abdominal cavity tube for drainage or dialysis,7037.0,3518.5,2111.1,9570.32,32
CDM,9223357,Declotting of central venous tube,1032.0,516.0,309.6,1403.52,32
CDM,9223358,Insertion of artery tube for blood sampling or infusion through skin,938.0,469.0,281.4,1275.68,32
CDM,9223369,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",2199.0,1099.5,659.7,2990.64,32
CDM,9223403,HB LASER SURGERY 1,100.0,50.0,30.0,60.0,2
CDM,9223404,HB LASER SURGERY 2,200.0,100.0,60.0,120.0,2
CDM,9223427,"Fine needle aspiration biopsy, first growth",1126.0,563.0,337.8,1531.36,30
CDM,9223429,Injection to cause blood clot in diseased or pseudoaneurysm of arm or leg,1293.0,646.5,387.9,1758.48,32
CDM,9223430,Destruction of growth of liver through skin using radiofrequency,12581.0,6290.5,3774.3,17110.16,32
CDM,9223444,HB PEEL SALYCYLIC,30.0,15.0,9.0,18.0,2
CDM,9223452,Review by radiologist of image for removal of obstructive material,1119.0,559.5,253.72,1521.84,32
CDM,9223468,HB HAIR REMOVALBIKINI,100.0,50.0,30.0,60.0,2
CDM,9223473,Insertion of shunts to bypass blood flow to liver with review by radiologist,9195.0,4597.5,2758.5,23603.71,32
CDM,9223474,Revision of shunts to bypass blood flow to liver with review by radiologist,13401.0,6700.5,4020.3,18225.36,32
CDM,9223475,Ultrasound measurement of bladder capacity after voiding,342.0,171.0,75.96,465.12,32
CDM,9223477,Application of light with debridement to destroy precancer skin growth,672.0,336.0,201.6,913.92,32
CDM,9223508,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),4922.0,2461.0,1377.13,6693.92,32
CDM,9223509,Insertion of non-tunneled central venous tube for infusion (5 years or older),4922.0,2461.0,1377.13,6693.92,32
CDM,9223511,Insertion of tunneled central venous tube for infusion (5 years or older),6262.0,3131.0,1878.6,8516.32,32
CDM,9223513,Insertion of central venous tube with port (5 years or older),11266.0,5633.0,2659.52,15321.76,32
CDM,9223517,Insertion of tube for infusion (younger than 5 years),2429.0,1214.5,728.7,3303.44,32
CDM,9223521,Repair of central venous tube for infusion,1706.0,853.0,511.8,2320.16,32
CDM,9223522,Repair of central venous tube for infusion with port or pump,2429.0,1214.5,728.7,3303.44,32
CDM,9223524,Replacement of nontunneled central venous tube,3724.0,1862.0,1117.2,5064.64,32
CDM,9223525,Replacement of tunneled central venous tube,5619.0,2809.5,1685.7,7641.84,32
CDM,9223526,Replacement of tunneled central venous tube with port,6387.0,3193.5,1916.1,8686.32,32
CDM,9223528,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,3172.0,1586.0,951.6,4313.92,32
CDM,9223530,Removal of tunneled central venous tube,2874.0,1437.0,807.71,3908.64,32
CDM,9223531,Removal of central venous tube with port or pump,3521.0,1760.5,925.11,4788.56,32
CDM,9223532,Mechanical removal of obstructive material from central venous tube,4922.0,2461.0,925.11,6693.92,32
CDM,9223534,Repositioning of central venous tube using fluoroscopic guidance,2429.0,1214.5,728.7,3303.44,32
CDM,9223535,REV - IHS-MOA CLINIC VISIT,60.0,30.0,15.0,88.0,8
CDM,9223537,Fluoroscopic guidance for insertion or removal of central vein access device,817.0,408.5,144.76,1111.12,32
CDM,9223538,Ultrasonic guidance for blood vessel access,715.0,357.5,54.02,972.4,32
CDM,9223552,Other procedure on blood vessel,1650.0,825.0,495.0,2786.62,32
CDM,9223560,Insertion of stent and blood clot protection device in neck artery with review by radiologist,7737.0,3868.5,2321.1,18704.53,32
CDM,9223584,Repair of descending aorta with insertion of graft and extensions,3125.0,1562.5,937.5,21839.3,32
CDM,9223587,Insertion of extension after previous repair of descending aorta,1875.0,937.5,562.5,21839.3,32
CDM,9223590,Contrast injection for imaging to evaluate central venous access device,1302.0,651.0,273.88,1770.72,32
CDM,9223591,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",28078.0,14039.0,7754.24,38186.08,32
CDM,9223592,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",5276.0,2638.0,1582.8,8219.5,32
CDM,9223593,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,7223.0,3611.5,2166.9,14230.97,32
CDM,9223594,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",17732.0,8866.0,4624.13,24115.52,32
CDM,9223595,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",6636.0,3318.0,1990.8,9024.96,32
CDM,9223596,Removal and replacement of stent in ureter with review by radiologist,5540.0,2770.0,1662.0,7534.4,32
CDM,9223597,Removal of stent in ureter through skin with review by radiologist,5508.0,2754.0,1652.4,7490.88,32
CDM,9223598,Removal and replacement of stent in kidney and ureter using fluoroscopic guidance with review by radiologist,4787.0,2393.5,1436.1,6510.32,32
CDM,9223599,Removal of kidney drainage tube using fluoroscopic guidance,2335.0,1167.5,506.45,3175.6,32
CDM,9223600,Destruction of growth of kidney using radiofrequency,10035.0,5017.5,3010.5,13647.6,32
CDM,9223606,Injection of chemical for paralysis of underarm sweat glands,672.0,336.0,201.6,913.92,32
CDM,9223607,Injection of chemical for paralysis of sweat glands,687.0,343.5,206.1,934.32,32
CDM,9223612,Destruction of growth of kidney by freezing,16279.0,8139.5,4883.7,22139.44,32
CDM,9223619,Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming,1250.0,625.0,122.41,1700.0,32
CDM,9223625,Removal of blood clot in artery of upper arm,9389.0,4694.5,2816.7,12769.04,32
CDM,9223627,Drainage of deep abscess in rectum,5115.0,2557.5,1534.5,6956.4,32
CDM,9223631,Insertion of small bowel tube using fluoroscopic guidance with contrast,3329.0,1664.5,488.25,4527.44,32
CDM,9223633,Conversion of stomach tube to stomach-to-small bowel tube using fluoroscopic guidance with contrast,3296.0,1648.0,488.25,4482.56,32
CDM,9223634,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,1890.0,945.0,488.25,2570.4,32
CDM,9223635,Replacement of small bowel tube using fluoroscopic guidance with contrast,2014.0,1007.0,488.25,2739.04,32
CDM,9223636,Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast,1932.0,966.0,488.25,2627.52,32
CDM,9223638,"Contrast injection for X-ray imaging through existing tube in stomach, small bowel or large bowel",780.0,390.0,148.54,1060.8,32
CDM,9223640,Insertion of stomach tube using fluoroscopic guidance with contrast,3263.0,1631.5,488.25,4437.68,32
CDM,9223642,Removal of abdominal cavity tube,6002.0,3001.0,905.56,8162.72,32
CDM,9223646,Destruction of face nerve branch under X-ray monitoring,4431.0,2215.5,1329.3,6026.16,32
CDM,9223648,Review by radiologist of adrenal gland artery image,4922.0,2461.0,211.73,6693.92,32
CDM,9223652,Review by radiologist of spleen and liver vein image,4922.0,2461.0,784.93,6693.92,32
CDM,9223654,Review by radiologist of both kidneys veins image,4971.0,2485.5,170.15,6760.56,32
CDM,9223662,Radioactive drug therapy through a tube inserted in an artery,1716.0,858.0,182.11,2333.76,32
CDM,9223663,Complex radiation therapy planning,901.0,450.5,150.79,1225.36,32
CDM,9223673,"Injection of upper or middle spine facet joint using imaging guidance, single level",2948.0,1474.0,884.4,4009.28,32
CDM,9223674,"Injection of upper or middle spine facet joint using imaging guidance, second level",1510.0,755.0,453.0,2053.6,32
CDM,9223676,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1021.0,510.5,306.3,1388.56,32
CDM,9223679,"Injection of lower or sacral spine facet joint using imaging guidance, single level",2388.0,1194.0,716.4,3247.68,32
CDM,9223681,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",11282.0,5641.0,3384.6,15343.52,32
CDM,9223683,Insertion of indwelling tube for drainage of lung fluid,7917.0,3958.5,1250.4,10767.12,32
CDM,9223686,Aspiration and/or injection of cyst of thyroid,1465.0,732.5,439.5,1992.4,32
CDM,9223689,Nuclear medicine study of kidney function,691.0,345.5,112.13,939.76,32
CDM,9223690,Injection into tendon or ligament,960.0,480.0,288.0,1305.6,32
CDM,9223707,Insertion of abdominal tube using imaging guidance with review by radiologist,7124.0,3562.0,2137.2,9688.64,32
CDM,9223715,Removal of indwelling tube in lining of lung,1968.0,984.0,590.4,2676.48,32
CDM,9223719,Aspiration of spinal disc tissue for diagnostic purposes,1621.0,810.5,486.3,2204.56,32
CDM,9223721,Injection procedure for imaging of lymphatic system,1875.0,937.5,411.09,2550.0,32
CDM,9223723,Insertion of vena cava filter with review by radiologist,10590.0,5295.0,3177.0,14402.4,32
CDM,9223725,Removal of vena cava filter with review by radiologist,10112.0,5056.0,3033.6,13752.32,32
CDM,9223726,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,9439.0,4719.5,2831.7,12837.04,32
CDM,9223728,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,7332.0,3666.0,2199.6,9971.52,32
CDM,9223729,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,8064.0,4032.0,2419.2,10967.04,32
CDM,9223734,Other procedure on abdomen,4442.0,2221.0,905.56,6041.12,32
CDM,9223735,Other procedure on liver,2773.0,1386.5,831.9,3771.28,32
CDM,9223743,Change of tube or stent in ureter,3523.0,1761.5,1056.9,4791.28,32
CDM,9223746,Other procedure on muscle or bone,6380.0,3190.0,317.61,8676.8,32
CDM,9223747,"Other procedure on skin, mucous membrane, and tissue",3750.0,1875.0,207.21,5100.0,32
CDM,9223748,Aspiration of fluid from chest cavity using imaging guidance,2219.0,1109.5,665.7,3017.84,32
CDM,9223749,Other procedure on urinary system,3962.0,1981.0,321.7,5388.32,32
CDM,9223756,Review by radiologist of abscess or sinus cavity study,857.0,428.5,53.24,1165.52,32
CDM,9223760,Occlusion of vein with review by radiologist,23982.0,11991.0,7194.6,32615.52,32
CDM,9223761,Occlusion of artery with review by radiologist,28078.0,14039.0,8423.4,38186.08,32
CDM,9223762,Occlusion of growths or obstructed vessels with review by radiologist,22844.0,11422.0,6853.2,31067.84,32
CDM,9223763,Occlusion of artery or vein bleeding with review by radiologist,34178.0,17089.0,10253.4,46482.08,32
CDM,9223764,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",17732.0,8866.0,5319.6,24115.52,32
CDM,9223765,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",13369.0,6684.5,4010.7,18181.84,32
CDM,9223769,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,3797.0,1898.5,905.56,5163.92,32
CDM,9223770,Drainage of fluid collection by tube through skin using imaging guidance,4461.0,2230.5,905.56,6066.96,32
CDM,9223773,"Insertion of stent in vein with review by radiologist, initial vein",18833.0,9416.5,5649.9,25612.88,32
CDM,9223774,"Insertion of stent in vein with review by radiologist, each additional vein",13494.0,6747.0,4048.2,18351.84,32
CDM,9223776,Repair of congenital abnormality of pulmonary artery to aorta,28078.0,14039.0,8423.4,38186.08,32
CDM,9223777,Drainage of fluid collection in soft tissue using imaging guidance,1500.0,750.0,450.0,2040.0,30
CDM,9223779,Other procedure on lung and lung lining,3559.0,1779.5,807.71,4840.24,32
CDM,9223784,Review by radiologist of lymphatic system of both side of pelvis and abdomen image,3623.0,1811.5,381.25,4927.28,32
CDM,9223785,Other fluoroscopic procedure,942.0,471.0,70.48,1281.12,32
CDM,9223788,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",11170.0,5585.0,3351.0,15191.2,32
CDM,9223791,Other blood vessel injection procedure,1650.0,825.0,495.0,2244.0,32
CDM,9223794,"Imaging guidance for procedure, 60 minutes or less",853.0,426.5,70.79,1160.08,32
CDM,9223796,Review by radiologist of CT guidance for needle placement,2864.0,1432.0,103.38,3895.04,32
CDM,9223803,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,1850.0,925.0,555.0,2516.0,32
CDM,9223823,Aspiration and/or injection of fluid from small joint,916.0,458.0,274.8,1245.76,32
CDM,9223828,Freezing of growth of bone and adjacent soft tissue,15000.0,7500.0,2246.0,20400.0,32
CDM,9223829,Stabilization of upper spine bone,8077.0,4038.5,2423.1,10984.72,32
CDM,9223830,Stabilization of lower spine bone,8199.0,4099.5,2459.7,11150.64,32
CDM,9223831,"Stabilization of spine bone, each additional bone",6557.0,3278.5,1967.1,8917.52,32
CDM,9223832,Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance,17500.0,8750.0,5250.0,23800.0,32
CDM,9223833,Treatment of broken lower spine bone with placement of stabilizing device,14215.0,7107.5,4264.5,19332.4,32
CDM,9223834,"Treatment of broken spine bone with stabilizing device, each additional segment",9371.0,4685.5,2811.3,12744.56,32
CDM,9223836,X-ray of upper spinal canal with review by radiologist,2437.0,1218.5,296.03,3314.32,32
CDM,9223838,X-ray of lower spinal canal with review by radiologist,2384.0,1192.0,254.54,3242.24,32
CDM,9223839,X-ray of multiple regions of spinal canal with review by radiologist,3018.0,1509.0,381.25,4104.48,32
CDM,9223841,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,1348.0,674.0,404.4,1833.28,32
CDM,9223842,Aspiration and/or injection of fluid large joint using ultrasound guidance,1650.0,825.0,395.23,2244.0,32
CDM,9223844,Destruction of growths and adjacent soft tissue,20119.0,10059.5,2246.0,27361.84,32
CDM,9223846,Aspiration and/or injection of cyst of tendon,862.0,431.0,258.6,1172.32,32
CDM,9223856,Ultrasound guided compression repair of blood vessel,1343.0,671.5,253.72,1826.48,32
CDM,9223858,ADJUSTMENT OF GASTRIC BAND DIAMETER VIA SUBCUTANEOUS PORT BY INJECTION OR ASPIRATION OF SALINE,1387.0,693.5,416.1,1886.32,28
CDM,9223860,Other procedure on pelvis or hip joint,8305.0,4152.5,317.61,11294.8,32
CDM,9223861,Injection of bile duct for X-ray through already existing skin access using imaging guidance with review by radiologist,5518.0,2759.0,1655.4,7504.48,32
CDM,9223862,Injection of bile duct for X-ray through new skin access using imaging guidance with review by radiologist,5685.0,2842.5,1705.5,7731.6,32
CDM,9223863,Placement of external drainage tube of biliary duct using imaging guidance with review by radiologist,6316.0,3158.0,1894.8,8589.76,32
CDM,9223864,Placement of internal-external drainage tube of biliary duct using imaging guidance with review by radiologist,6443.0,3221.5,1932.9,8762.48,32
CDM,9223865,Conversion of external biliary drainage tube to internal-external biliary drainage tube using imaging guidance and study of bile duct with review by radiologist,6192.0,3096.0,1857.6,8421.12,32
CDM,9223866,Replacement of liver duct drainage tube using imaging guidance with review by radiologist,6130.0,3065.0,1839.0,8336.8,32
CDM,9223867,Removal of biliary drainage tube using imaging guidance with review by radiologist,2802.0,1401.0,488.25,3810.72,32
CDM,9223868,Placement of stent of biliary duct through existing skin access using imaging guidance with review by radiologist,10035.0,5017.5,2780.12,13647.6,32
CDM,9223870,Placement of stent and drainage tube of biliary duct using imaging guidance with review by radiologist,9306.0,4653.0,2791.8,12656.16,32
CDM,9223872,Balloon dilation of bile duct using imaging guidance with review by radiologist,8875.0,4437.5,2662.5,12070.0,32
CDM,9223873,Biopsy of bile duct or liver duct using imaging guidance with review by radiologist,3118.0,1559.0,935.4,7213.17,32
CDM,9223875,Injection of chemical agent into fluid collection using imaging guidance,4145.0,2072.5,905.56,5637.2,32
CDM,9223876,Injection procedure for imaging of kidney and ureter through new skin access using imaging guidance with review by radiologist,1529.0,764.5,458.7,2079.44,32
CDM,9223877,Injection procedure for imaging of kidney and ureter through already existing skin access using imaging guidance with review by radiologist,3784.0,1892.0,506.45,5146.24,32
CDM,9223878,Placement of tube of kidney using imaging guidance with review by radiologist,4629.0,2314.5,1388.7,6295.44,32
CDM,9223879,Placement of tube of kidney and urinary tube through new skin access using imaging guidance with review by radiologist,5932.0,2966.0,1779.6,8067.52,32
CDM,9223880,Replacement of kidney drainage tube using imaging guidance with review by radiologist,4392.0,2196.0,1317.6,5973.12,32
CDM,9223881,Placement of stent of ureter through existing skin access using imaging guidance with review by radiologist,7293.0,3646.5,2187.9,9918.48,32
CDM,9223882,Placement of stent of ureter through new skin access using imaging guidance with review by radiologist,6962.0,3481.0,2088.6,9468.32,32
CDM,9223885,Balloon dilation treatment of stricture of ureter using imaging guidance with review by radiologist,7925.0,3962.5,2377.5,10778.0,32
CDM,9223887,Insertion of pulmonary valve,14244.0,7122.0,4273.2,19371.84,32
CDM,9223888,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",4297.0,2148.5,1289.1,5843.92,28
CDM,9223889,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",3009.0,1504.5,902.7,4092.24,28
CDM,9223891,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, initial territory",4224.0,2112.0,1267.2,18704.53,32
CDM,9223892,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, each additional territory",3119.0,1559.5,935.7,18704.53,32
CDM,9223893,Conversion of kidney tube to nephroureteral tube using imaging guidance and study of kidney and ureter with review by radiologist,4392.0,2196.0,1317.6,5973.12,32
CDM,9223897,Injection of substance into middle or upper spine canal using imaging guidance,2063.0,1031.5,618.9,2805.68,32
CDM,9223898,Injection of substance into lower spine canal using imaging guidance,2467.0,1233.5,740.1,3355.12,32
CDM,9223903,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,4620.0,2310.0,1386.0,6283.2,32
CDM,9223904,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,21509.0,10754.5,4624.13,29252.24,32
CDM,9223905,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,33726.0,16863.0,10117.8,45867.36,32
CDM,9223906,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,9807.0,4903.5,2942.1,13337.52,32
CDM,9223907,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",27071.0,13535.5,7754.24,36816.56,32
CDM,9223908,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,43835.0,21917.5,13150.5,59615.6,32
CDM,9223909,Balloon dilation of dialysis segment with review by radiologist,11930.0,5965.0,3579.0,16224.8,32
CDM,9223910,Insertion of stent in dialysis segment with review by radiologist,19043.0,9521.5,5712.9,25898.48,32
CDM,9223911,Permanent blockage of hemodialysis circuit with review by radiologist,17146.0,8573.0,5143.8,23318.56,32
CDM,9223912,"Balloon dilation of artery with review by radiologist, initial artery",10467.0,5233.5,3140.1,14235.12,32
CDM,9223913,"Balloon dilation of artery with review by radiologist, each additional artery",10081.0,5040.5,3024.3,13710.16,32
CDM,9223914,"Balloon dilation of vein with review by radiologist, initial vein",9807.0,4903.5,2942.1,13337.52,32
CDM,9223915,"Balloon dilation of vein with review by radiologist, each additional vein",7992.0,3996.0,2397.6,10869.12,32
CDM,9223918,Other procedure on female genital system (nonobstetrical),2624.0,1312.0,260.32,3568.64,32
CDM,9223919,"Placement of stent in lung airway using an endoscope, first stent",12266.0,6133.0,3679.8,16681.76,32
CDM,9223921,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1425.0,712.5,427.5,1938.0,32
CDM,9223925,Repair of infrarenal aorta and groin artery with graft for other than rupture with review by radiologist,9629.0,4814.5,2888.7,21839.3,32
CDM,9223927,Repair of infrarenal aorta and groin artery with graft for other than rupture on both sides with review by radiologist,10110.0,5055.0,3033.0,21839.3,32
CDM,9223928,Repair of abdominal or groin artery with prosthesis with review by radiologist,8124.0,4062.0,2437.2,21839.3,32
CDM,9223931,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, initial vessel treated",5800.0,2900.0,1740.0,21839.3,32
CDM,9223934,Destruction of growth of lung using extreme cold,16279.0,8139.5,4883.7,22139.44,32
CDM,9223945,Drainage of heart sac using imaging guidance,2948.0,1474.0,884.4,4009.28,32
CDM,9223946,Drainage of heart sac using tube and imaging guidance (6 years or older),2985.0,1492.5,895.5,4059.6,32
CDM,9223949,Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance,3332.0,1666.0,908.89,4531.52,32
CDM,9223950,Removal of cerebrospinal fluid with lower back spinal tap using imaging guidance,3411.0,1705.5,908.89,4638.96,32
CDM,9223953,Insertion of needle into vein (younger than 3 years),150.0,75.0,3.43,204.0,32
CDM,9223956,Repair of aorta by insertion of stent not crossing major side branches,4518.0,2259.0,1355.4,21839.3,32
CDM,9231361,Single contrast X-ray of large intestine,731.0,365.5,106.53,994.16,32
CDM,9231371,"X-ray of skull, 1-3 views",390.0,195.0,38.12,530.4,32
CDM,9231400,Review by radiologist of urinary bladder and urethra images with contrast,882.0,441.0,91.95,1199.52,32
CDM,9231401,Imaging of urinary tract following injection of a contrast agent,1000.0,500.0,148.54,1360.0,32
CDM,9231462,X-ray of both collar bones joints,381.0,190.5,41.49,518.16,32
CDM,9231473,"X-ray of ankle, minimum of 3 views",480.0,240.0,32.53,652.8,32
CDM,9231488,X-ray for estimating bone age,625.0,312.5,25.31,850.0,32
CDM,9231490,Complete X-ray of body bones,945.0,472.5,89.71,1285.2,32
CDM,9231506,X-ray of collar bone,317.0,158.5,33.64,431.12,32
CDM,9231507,Double contrast X-ray of large intestine,799.0,399.5,140.17,1086.64,32
CDM,9231509,Review by radiologist of urinary bladder and urethra images with contrast and after passing urine,925.0,462.5,98.68,1258.0,32
CDM,9231513,"X-ray of elbow, minimum of 3 views",477.0,238.5,35.89,648.72,32
CDM,9231514,Single contrast X-ray of esophagus,481.0,240.5,70.48,654.16,32
CDM,9231516,"X-ray of face bones, minimum of 3 views",429.0,214.5,49.33,583.44,32
CDM,9231518,"X-ray of finger, minimum of 2 views",612.0,306.0,25.79,832.32,32
CDM,9231519,"Imaging guidance for procedure, 60 minutes or less",853.0,426.5,70.79,1160.08,32
CDM,9231520,Imaging for evaluation of swallowing function,566.0,283.0,80.74,769.76,32
CDM,9231521,"X-ray of foot, minimum of 3 views",632.0,316.0,32.53,859.52,32
CDM,9231524,"X-ray of hand, minimum of 3 views",626.0,313.0,32.53,851.36,32
CDM,9231526,"X-ray of heel, minimum of 2 views",293.0,146.5,30.28,398.48,32
CDM,9231529,"X-ray of upper arm, minimum of 2 views",398.0,199.0,35.89,541.28,32
CDM,9231533,"X-ray of knee, 4 or more views",693.0,346.5,39.25,942.48,32
CDM,9231534,"X-ray of knee, 3 views",604.0,302.0,35.89,821.44,32
CDM,9231535,"X-ray of knee, 1-2 views",384.0,192.0,32.53,522.24,32
CDM,9231537,"X-ray of lower and sacral spine, minimum of 4 views",733.0,366.5,57.19,996.88,32
CDM,9231538,"X-ray of lower and sacral spine, 2-3 views",481.0,240.5,42.61,654.16,32
CDM,9231540,"X-ray of lower jaw, minimum of 4 views",414.0,207.0,38.12,563.04,32
CDM,9231550,"X-ray of nose bones, minimum of 3 views",375.0,187.5,32.53,510.0,32
CDM,9231551,X-ray of soft tissue of neck,368.0,184.0,25.79,500.48,32
CDM,9231555,"X-ray of pelvis, 1-2 views",436.0,218.0,32.53,592.96,32
CDM,9231556,"X-ray of pelvis, minimum of 3 views",544.0,272.0,42.61,739.84,32
CDM,9231561,"X-ray of forearm, 2 views",396.0,198.0,31.8,538.56,32
CDM,9231565,"X-ray of joint between lower spine and hip bone, 3 or more views",922.0,461.0,39.25,1253.92,32
CDM,9231566,X-ray of shoulder blade,501.0,250.5,32.53,681.36,32
CDM,9231570,"X-ray of shoulder, minimum of 2 views",675.0,337.5,35.7,918.0,32
CDM,9231573,Review by radiologist of abscess or sinus cavity study,857.0,428.5,53.24,1165.52,32
CDM,9231574,"X-ray of paranasal sinus, minimum of 3 views",459.0,229.5,45.45,624.24,32
CDM,9231575,"X-ray of skull, minimum of 4 views",465.0,232.5,51.29,632.4,32
CDM,9231576,Single contrast X-ray of small intestine,592.0,296.0,80.74,805.12,32
CDM,9231580,"X-ray of sacrum and tailbone, minimum of 2 views",472.0,236.0,35.7,641.92,32
CDM,9231584,"X-ray of joint between breast and collar bones, minimum of 2 views",440.0,220.0,43.74,598.4,32
CDM,9231585,"X-ray of chest bone, minimum of 2 views",431.0,215.5,35.7,586.16,32
CDM,9231586,Single contrast X-ray of upper digestive tract,538.0,269.0,90.83,731.68,32
CDM,9231589,X-ray of jaw joints on both sides of mouth,417.0,208.5,51.58,567.12,32
CDM,9231590,"X-ray of middle spine, minimum of 4 views",683.0,341.5,51.94,928.88,32
CDM,9231592,"X-ray of middle spine, 3 views",450.0,225.0,43.49,612.0,32
CDM,9231593,"X-ray of lower leg, 2 views",450.0,225.0,32.53,612.0,32
CDM,9231594,"X-ray of toe, minimum of 2 views",437.0,218.5,25.79,594.32,32
CDM,9231596,Review by radiologist of placement of long small bowel tube,702.0,351.0,164.83,954.72,32
CDM,9231606,"X-ray of wrist, minimum of 3 views",311.0,155.5,32.53,422.96,32
CDM,9231617,"X-ray of ribs on side of body, minimum of 3 views",576.0,288.0,41.55,783.36,32
CDM,9231618,"X-ray of ribs on both sides of body, minimum of 4 views",643.0,321.5,57.14,874.48,32
CDM,9231619,"X-ray of upper spine, 2-3 views",513.0,256.5,38.12,697.68,32
CDM,9231620,"X-ray of upper spine, 4-5 views",705.0,352.5,53.24,958.8,32
CDM,9231621,"X-ray of upper spine, 6 or more views",731.0,365.5,69.48,994.16,32
CDM,9231622,"X-ray of spine, 1 view",269.0,134.5,26.6,365.84,32
CDM,9231624,"X-ray of infant arm, minimum of 2 views",287.0,143.5,31.39,390.32,32
CDM,9231626,X-ray of both knees while standing,430.0,215.0,31.39,584.8,32
CDM,9231627,"X-ray of infant leg, minimum of 2 views",267.0,133.5,31.39,363.12,32
CDM,9231629,Double contrast X-ray of upper digestive tract,1035.0,517.5,103.16,1407.6,32
CDM,9231634,Review by radiologist of urinary bladder image,796.0,398.0,39.6,1082.56,32
CDM,9231637,Injection procedure for imaging of bladder during voiding,1110.0,555.0,333.0,1509.6,32
CDM,9231640,X-ray of infant body bones,413.0,206.5,45.98,561.68,32
CDM,9231641,Injection of abnormal muscle drainage tract for X-ray study,1056.0,528.0,316.8,1436.16,32
CDM,9231643,"Creation of shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",11673.0,5836.5,3501.9,19194.56,32
CDM,9231702,Injection of contrast for imaging of shoulder joint,953.0,476.5,285.9,1296.08,32
CDM,9231706,Injection of contrast for imaging of wrist,1104.0,552.0,331.2,1501.44,32
CDM,9231708,Injection of contrast for imaging of hip joint,1155.0,577.5,346.5,1570.8,32
CDM,9231748,Dilation of stomach and/or small bowel using long gastrointestinal tube,1466.0,733.0,439.8,1993.76,32
CDM,9231908,X-ray from nose to rectum,213.0,106.5,31.15,289.68,32
CDM,9231917,"X-ray of joint between lower spine and hip bone, 1-2 views",583.0,291.5,32.53,792.88,32
CDM,9231918,"X-ray of shoulder, 1 view",257.0,128.5,27.9,349.52,32
CDM,9231919,"X-ray of elbow, 2 views",253.0,126.5,32.53,344.08,32
CDM,9231920,"X-ray of hand, 2 views",362.0,181.0,31.39,492.32,32
CDM,9231923,"X-ray of ankle, 2 views",360.0,180.0,31.39,489.6,32
CDM,9231924,"X-ray of foot, 2 views",351.0,175.5,31.39,477.36,32
CDM,9231926,X-ray series of abdomen with single X-ray of chest,600.0,300.0,47.09,816.0,32
CDM,9231930,"X-ray of part of lower jaw, 1-4 views",328.0,164.0,32.53,446.08,32
CDM,9231933,"X-ray of face bones, 1-2 views",338.0,169.0,35.05,459.68,32
CDM,9231935,"X-ray of eye socket, minimum of 4 views",469.0,234.5,49.33,637.84,32
CDM,9231949,"X-ray of ribs on side of body, 2 views",542.0,271.0,35.89,737.12,32
CDM,9231950,"X-ray of ribs on both sides of body, 3 views",589.0,294.5,43.49,801.04,32
CDM,9231952,"X-ray of middle and lower spine, 2 views",394.0,197.0,36.35,535.84,32
CDM,9231953,"X-ray lower and sacral spine, minimum of 6 views",1561.0,780.5,70.48,2122.96,32
CDM,9233051,"X-ray of middle spine, 2 views",443.0,221.5,41.49,602.48,32
CDM,9233052,"X-ray of wrist, 2 views",300.0,150.0,31.39,408.0,32
CDM,9233054,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1425.0,712.5,427.5,1938.0,32
CDM,9233060,"HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML",4.0,2.0,0.43,5.44,28
CDM,9233062,Fluoroscopic guidance for spine or back muscle injection,967.0,483.5,83.59,1315.12,32
CDM,9233064,"X-ray of lower jaws, upper jaws and teeth",392.0,196.0,17.5,533.12,32
CDM,9233077,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",3.0,1.5,0.12,4.08,28
CDM,9233078,HB BOTOX INJECTION,9.0,4.5,2.7,5.4,2
CDM,9233079,HB VOLUMA INJECTION,400.0,200.0,120.0,240.0,2
CDM,9233080,HB RESTYLANE INJECTION,300.0,150.0,90.0,180.0,2
CDM,9233090,HB EAR LOBE REPAIR,200.0,100.0,60.0,120.0,2
CDM,9233091,HB EAR LOBE  REPAIR BILATERAL SIMPLE,400.0,200.0,120.0,240.0,2
CDM,9233094,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",947.0,473.5,75.32,1287.92,32
CDM,9233098,"X-ray of hip, 1 view",328.0,164.0,29.15,446.08,32
CDM,9233099,"X-ray of hip, 2-3 views",374.0,187.0,37.0,508.64,32
CDM,9233100,"X-ray of hip, minimum of 4 views",546.0,273.0,37.0,742.56,32
CDM,9233101,"X-ray of both hips, 2 views",561.0,280.5,41.49,762.96,32
CDM,9233102,"X-ray of both hips, 3-4 views",604.0,302.0,41.49,821.44,32
CDM,9233103,"X-ray of both hips, minimum of 5 views",823.0,411.5,41.49,1119.28,32
CDM,9233104,"X-ray of thigh bone, 1 view",339.0,169.5,35.7,461.04,32
CDM,9233105,"X-ray of thigh bone, minimum 2 views",367.0,183.5,35.89,499.12,32
CDM,9233106,"X-ray of entire middle and lower spine, 1 view",503.0,251.5,41.49,684.08,32
CDM,9233107,"X-ray of entire middle and lower spine, 2-3 views",566.0,283.0,63.91,769.76,32
CDM,9233108,"X-ray of entire middle and lower spine, 4-5 views",1020.0,510.0,41.49,1387.2,32
CDM,9233109,"X-ray of entire middle and lower spine, minimum of 6 views",1268.0,634.0,41.49,1724.48,32
CDM,9233112,"X-ray of chest, 1 view",397.0,198.5,32.66,539.92,32
CDM,9233113,"X-ray of chest, 2 views",567.0,283.5,38.11,771.12,32
CDM,9233114,"X-ray of chest, 3 views",587.0,293.5,44.64,798.32,32
CDM,9233115,"X-ray of chest, minimum of 4 views",746.0,373.0,47.9,1014.56,32
CDM,9233116,"X-ray of abdomen, 1 view",516.0,258.0,31.57,701.76,32
CDM,9233117,"X-ray of abdomen, 2 views",534.0,267.0,34.84,726.24,32
CDM,9233118,"X-ray of abdomen, minimum of 3 views",592.0,296.0,39.25,805.12,32
CDM,9233124,Injection of contrast for imaging of tear sac,223.0,111.5,66.9,435.76,32
CDM,9233125,Review by radiologist of tear drainage structure of eye image,947.0,473.5,59.43,1287.92,32
CDM,9233138,HB PULSE DYE LASER (PDL) LEVEL 1,80.0,40.0,24.0,48.0,2
CDM,9233139,HB PULSE DYE LASER (PDL) LEVEL 2,120.0,60.0,36.0,72.0,2
CDM,9233140,HB PULSE DYE LASER (PDL) LEVEL 3,160.0,80.0,48.0,96.0,2
CDM,9233141,HB PULSE DYE LASER (PDL) LEVEL 4,200.0,100.0,60.0,120.0,2
CDM,9261166,X-ray of eye for detection of foreign body,158.0,79.0,25.79,214.88,32
CDM,9261231,"X-ray lower and sacral spine, 2-3 views bending views",539.0,269.5,53.24,733.04,32
CDM,9261247,Review by radiologist of shoulder joint image,885.0,442.5,131.2,1203.6,32
CDM,9261257,Review by radiologist of wrist joint image,759.0,379.5,97.56,1032.24,32
CDM,9261265,Review by radiologist of hip joint image,1117.0,558.5,131.2,1519.12,32
CDM,9261334,Review by radiologist of uterine tube and ovary image,2504.0,1252.0,81.86,3405.44,32
CDM,9261339,Fluoroscopic guidance for needle placement,1361.0,680.5,81.86,1850.96,32
CDM,9261342,X-ray for bone length assessment,289.0,144.5,39.6,393.04,32
CDM,9261397,"DXA bone density measurement of forearm, finger, hand, or foot",720.0,360.0,31.8,979.2,32
CDM,9261445,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,32
CDM,9261468,Injection procedure to cause erection,1045.0,522.5,108.16,1421.2,32
CDM,9261471,Injection procedure to correct thickened penile tissue,690.0,345.0,108.16,938.4,32
CDM,9261472,Review by radiologist of image for drainage of fluid,2322.0,1161.0,196.23,3157.92,32
CDM,9261477,Needle biopsy of saliva gland,2001.0,1000.5,600.3,2721.36,32
CDM,9261478,Aspiration and/or injection of fluid from medium joint,1110.0,555.0,308.97,1509.6,32
CDM,9261479,"DXA bone density measurement of hip, pelvis, spine",729.0,364.5,57.14,991.44,32
CDM,9264135,Injection procedure through bladder and urethra for X-ray imaging,1591.0,795.5,411.09,2163.76,32
CDM,9264138,Double contrast X-ray of esophagus,606.0,303.0,71.86,824.16,32
CDM,9264139,Follow-through X-ray of small intestines,681.0,340.5,50.84,926.16,32
CDM,9271001,Ultrasound of both sides of head and neck blood flow,2298.0,1149.0,180.4,3125.28,32
CDM,9271003,Ultrasound study of arm or leg veins with compression and maneuvers,1850.0,925.0,164.82,2516.0,32
CDM,9271004,Ultrasound study of one arm or leg veins with compression and maneuvers,1552.0,776.0,122.56,2110.72,32
CDM,9271005,Complete ultrasound study of arm and leg arteries,1169.0,584.5,114.87,1589.84,32
CDM,9271006,Ultrasound study of arm and leg arteries,782.0,391.0,81.53,1063.52,32
CDM,9271007,Ultrasound of leg arteries at rest and after exercise,1598.0,799.0,137.18,2173.28,32
CDM,9271008,Ultrasound of leg arteries or artery grafts,1869.0,934.5,162.46,2541.84,32
CDM,9271009,Ultrasound of one leg arteries or artery grafts,1254.0,627.0,132.5,1705.44,32
CDM,9271010,Ultrasound of arm arteries or artery grafts,1516.0,758.0,137.18,2061.76,32
CDM,9271011,Ultrasound of one arm arteries or artery grafts,1077.0,538.5,134.61,1464.72,32
CDM,9271012,Ultrasound of hemodialysis access,1025.0,512.5,134.61,1394.0,32
CDM,9271013,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",1470.0,735.0,211.36,1999.2,32
CDM,9271014,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",1059.0,529.5,134.61,1440.24,32
CDM,9271015,Complete ultrasound of abdomen and pelvis artery and vein blood flow,2423.0,1211.5,137.99,3295.28,32
CDM,9271016,Ultrasound of abdomen and pelvis artery and vein blood flow,1334.0,667.0,134.61,1814.24,32
CDM,9271018,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",438.0,219.0,131.4,595.68,28
CDM,9271028,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",257.0,128.5,77.1,349.52,28
CDM,9271097,Ultrasound scan of brain,732.0,366.0,87.46,995.52,32
CDM,9271103,Ultrasound scan of head and neck soft tissue,1238.0,619.0,88.59,1683.68,32
CDM,9271104,Ultrasound scan of chest,685.0,342.5,81.86,931.6,32
CDM,9271105,Complete ultrasound scan of abdomen,1500.0,750.0,123.35,2040.0,32
CDM,9271106,Limited ultrasound scan of abdomen,1063.0,531.5,89.71,1445.68,32
CDM,9271107,Complete ultrasound scan behind abdominal cavity,1172.0,586.0,123.35,1593.92,32
CDM,9271108,Limited ultrasound scan behind abdominal cavity,864.0,432.0,53.88,1175.04,32
CDM,9271109,Ultrasound scan of transplanted kidney,1264.0,632.0,134.61,1719.04,32
CDM,9271110,Ultrasound scan of spinal canal,799.0,399.5,89.71,1086.64,32
CDM,9271111,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",1104.0,552.0,126.37,1501.44,32
CDM,9271112,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",984.0,492.0,126.37,1338.24,32
CDM,9271113,Limited ultrasound of pregnant uterus,821.0,410.5,88.59,1116.56,32
CDM,9271115,Ultrasound and monitoring of heart of fetus,1691.0,845.5,100.92,2299.76,32
CDM,9271119,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",1028.0,514.0,95.32,1398.08,32
CDM,9271120,Ultrasound scan of uterus and uterine cavity,1216.0,608.0,150.69,1653.76,32
CDM,9271121,Complete ultrasound scan of pelvis,1325.0,662.5,95.32,1802.0,32
CDM,9271122,Limited ultrasound scan of pelvis,980.0,490.0,42.19,1332.8,32
CDM,9271123,Ultrasound scan of scrotum,1130.0,565.0,65.59,1536.8,32
CDM,9271124,Ultrasound scan of pelvic region through rectum,1262.0,631.0,95.32,1716.32,32
CDM,9271133,Ultrasonic guidance for needle placement,1398.0,699.0,95.32,1901.28,32
CDM,9271134,Ultrasonic guidance for removal of amniotic fluid,1661.0,830.5,95.32,2258.96,32
CDM,9271145,Ultrasound of one side of head and neck blood flow,963.0,481.5,134.61,1309.68,32
CDM,9271162,Complete ultrasound of penis artery and vein blood flow,1447.0,723.5,109.76,1967.92,32
CDM,9271417,Ultrasound scan of fetus,1496.0,748.0,90.91,2034.56,32
CDM,9271418,Insertion of drug delivery implant into tissue,446.0,223.0,133.8,606.56,32
CDM,9271437,"Aspiration of abscess, blood, or cyst",925.0,462.5,207.21,1258.0,32
CDM,9271440,Needle biopsy of muscle,3438.0,1719.0,857.07,4675.68,32
CDM,9271441,Deep biopsy of bone using needle or trocar,3985.0,1992.5,1195.5,5419.6,32
CDM,9271453,Needle biopsy of thyroid through skin,2196.0,1098.0,658.8,2986.56,32
CDM,9271460,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",821.0,410.5,126.37,1116.56,32
CDM,9271461,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",750.0,375.0,106.01,1020.0,32
CDM,9271462,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",1095.0,547.5,126.37,1489.2,32
CDM,9271464,Vaginal ultrasound of pregnant uterus,799.0,399.5,109.11,1086.64,32
CDM,9271465,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,853.0,426.5,255.9,1160.08,32
CDM,9271468,Ultrasound scan of fetal umbilical artery blood flow rate,791.0,395.5,40.25,1075.76,32
CDM,9271472,Insertion of tube into fallopian tube,4972.0,2486.0,1491.6,6761.92,32
CDM,9271473,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",811.0,405.5,111.06,1102.96,32
CDM,9271474,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",711.0,355.5,119.27,966.96,32
CDM,9271476,Ultrasound of penis artery and vein blood flow,436.0,218.0,94.82,592.96,32
CDM,9274123,Follow-up ultrasound scan of pregnant uterus,818.0,409.0,69.52,1112.48,32
CDM,9274125,Aspiration and/or injection of cyst of thyroid,1465.0,732.5,439.5,1992.4,32
CDM,9274126,Injection into tendon or ligament,960.0,480.0,288.0,1305.6,32
CDM,9274127,Injection into tendon at attachment to bone or muscle,979.0,489.5,293.7,1331.44,32
CDM,9274128,Needle biopsy of kidney,3890.0,1945.0,1167.0,5290.4,32
CDM,9274129,Complete ultrasound scan of joint,990.0,495.0,134.61,1346.4,32
CDM,9274130,Limited ultrasound scan of joint or other extremity structure except blood vessels,789.0,394.5,21.4,1073.04,32
CDM,9274131,Drainage of fluid from abdominal cavity using imaging guidance,2605.0,1302.5,781.5,3542.8,32
CDM,9274134,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,3797.0,1898.5,905.56,5163.92,32
CDM,9274135,Drainage of fluid collection by tube through skin using imaging guidance,4461.0,2230.5,905.56,6066.96,32
CDM,9274138,Ultrasound scan of abdominal aorta,582.0,291.0,89.71,791.52,32
CDM,9274139,Removal of tissue from placenta for diagnosis,1813.0,906.5,543.9,2465.68,32
CDM,9274142,Ultrasonic guidance for testing placental tissue,1286.0,643.0,95.32,1748.96,32
CDM,9274146,"Fine needle aspiration biopsy using ultrasound guidance, first growth",3326.0,1663.0,857.07,4523.36,30
CDM,9274147,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",1307.0,653.5,392.1,1777.52,30
CDM,9274148,Ultrasound scan of organ tissue for measuring elasticity,824.0,412.0,134.61,1120.64,32
CDM,9274151,Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access,1185.0,592.5,137.18,1611.6,32
CDM,9274152,Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access,820.0,410.0,134.61,1115.2,32
CDM,9281003,"Nuclear medicine study, SPECT imaging, 1 area or single acquisition, single day imaging",3556.0,1778.0,408.16,4836.16,32
CDM,9281008,Nuclear medicine study of bone taken at different times,3015.0,1507.5,298.28,4100.4,32
CDM,9281012,Nuclear medicine study of bone and/or joint whole body,2310.0,1155.0,266.87,3141.6,32
CDM,9281017,Injection of radioactive material for X-ray identification of lymph node,1203.0,601.5,360.9,1636.08,32
CDM,9281018,Exposure of lymph duct of chest cavity,1283.0,641.5,384.9,1744.88,32
CDM,9281024,Nuclear medicine study of stomach to assess emptying,1961.0,980.5,256.79,2666.96,32
CDM,9281025,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,2391.0,1195.5,344.25,3251.76,32
CDM,9281029,Nuclear medicine study to assess blood loss,1745.0,872.5,303.89,2373.2,32
CDM,9281031,Nuclear medicine study of whole body for thyroid cancer,3101.0,1550.5,338.64,4217.36,32
CDM,9281036,Nuclear medicine study of liver and spleen,1506.0,753.0,182.78,2048.16,32
CDM,9281038,Nuclear medicine study of lung circulation,1434.0,717.0,214.17,1950.24,32
CDM,9281041,Nuclear medicine study of intestine,3189.0,1594.5,189.5,4337.04,32
CDM,9281045,"Nuclear medicine study, whole body",3515.0,1757.5,345.36,4780.4,32
CDM,9281047,Nuclear medicine study of parathyroid,2189.0,1094.5,113.26,2977.04,32
CDM,9281121,Nuclear medicine study of lymphatic system,3039.0,1519.5,254.54,4133.04,32
CDM,9281144,Nuclear medicine study of brain and blood flow,1162.0,581.0,211.93,1580.32,32
CDM,9281155,"Nuclear medicine study of kidney, blood flow, and function",1778.0,889.0,279.21,2418.08,32
CDM,9281156,"Nuclear medicine study of kidney, blood, flow, and function with drug administration",2763.0,1381.5,222.06,3757.68,32
CDM,9281204,"Nuclear medicine study, whole body requiring multiple imaging days",4258.0,2129.0,699.13,5790.88,32
CDM,9281214,Nuclear medicine study to assess the degree of openness of shunt from jugular vein to abdominal cavity,986.0,493.0,191.75,1340.96,32
CDM,9281215,Nuclear medicine study of heart muscle at rest and with stress and SPECT,3553.0,1776.5,524.16,4832.08,32
CDM,9281216,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,5447.0,2723.5,752.78,7407.92,32
CDM,9281221,"Nuclear medicine study of plasma volume, multiple samplings",4500.0,2250.0,160.36,6120.0,32
CDM,9281222,Nuclear medicine study of lung ventilation and circulation,1947.0,973.5,350.98,2647.92,32
CDM,9281223,Nuclear medicine study of liver and bile duct system,2198.0,1099.0,461.21,2989.28,32
CDM,9281224,Nuclear medicine study of lung ventilation,839.0,419.5,310.61,1170.94,32
CDM,9281225,Nuclear medicine study of lung ventilation and circulation and blood flow to lung,2020.0,1010.0,440.68,2747.2,32
CDM,9281226,Nuclear medicine study of liver and bile duct system with use of drugs,2475.0,1237.5,461.21,3366.0,32
CDM,9281228,Nuclear medicine study of bone marrow limited area,1331.0,665.5,126.71,1810.16,32
CDM,9281232,Nuclear medicine study of thyroid and thyroid function,3258.0,1629.0,161.47,4430.88,32
CDM,9281236,"Nuclear medicine study, multiple areas",2289.0,1144.5,263.52,3113.04,32
CDM,9281244,Nuclear medicine study of parathyroid with SPECT and CT scan,6542.0,3271.0,113.26,8897.12,32
CDM,9281245,Nuclear medicine study of heart muscle with metabolic evaluation,6346.0,3173.0,1575.0,8630.56,32
CDM,9281246,CT scan of heart with evaluation of blood vessel calcium,1135.0,567.5,112.05,1543.6,32
CDM,9281249,Nuclear medicine study of blood flow in heart muscle at rest and with stress with concurrent CT scan,5827.0,2913.5,1575.0,7924.72,32
CDM,9281250,Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent CT scan,6651.0,3325.5,1575.0,9045.36,31
CDM,9281252,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections and concurrent CT scan,10514.0,5257.0,1575.0,14299.04,31
CDM,9281253,Nuclear medicine study of heart muscle blood flow by PET,2890.0,1445.0,924.8,3930.4,32
CDM,9281257,"Nuclear medicine study, SPECT imaging with concurrent CT scan, 1 area or single acquisition, single day imaging",3897.0,1948.5,570.12,5299.92,64
CDM,9281259,"Nuclear medicine study, SPECT imaging with concurrent CT scan, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",6283.0,3141.5,837.0,8544.88,64
CDM,9281260,Quantification of radioactive materials,2015.0,1007.5,461.21,2740.4,32
CDM,9281262,"Nuclear medicine study of red blood cell volume, multiple samples",1605.0,802.5,164.92,2182.8,32
CDM,9291016,X-ray of surgical specimen,1034.0,517.0,16.21,1406.24,32
CDM,9291019,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",390.0,195.0,117.0,530.4,28
CDM,9291031,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",5495.0,2747.5,1648.5,7473.2,32
CDM,9291032,"Biopsy of breast and placement of locating device using X-ray with needle, each additional growth",4021.0,2010.5,1206.3,5468.56,32
CDM,9291033,"Biopsy of breast and placement of locating device using ultrasound, first growth",5153.0,2576.5,1545.9,7008.08,32
CDM,9291034,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",3767.0,1883.5,1130.1,5123.12,32
CDM,9291035,"Biopsy of breast and placement of locating device using MRI, first growth",5877.0,2938.5,1669.7,7992.72,32
CDM,9291036,"Biopsy of breast and placement of locating device using MRI, each additional growth",3847.0,1923.5,1154.1,5231.92,32
CDM,9291037,"Placement of locating device in breast using imaging guidance, first growth",3254.0,1627.0,976.2,4425.44,32
CDM,9291038,"Placement of locating device in breast using imaging guidance, each additional growth",1813.0,906.5,543.9,2465.68,32
CDM,9291039,"Placement of locating device in breast using X-ray with needle guidance, first growth",1307.0,653.5,392.1,1777.52,32
CDM,9291040,"Placement of locating device in breast using X-ray with needle guidance, each additional growth",1090.0,545.0,327.0,1769.88,32
CDM,9291041,"Placement of locating device in breast using ultrasound guidance, first growth",3010.0,1505.0,903.0,4093.6,32
CDM,9291042,"Placement of locating device in breast using ultrasound guidance, each additional growth",894.0,447.0,268.2,1769.88,32
CDM,9291043,"Placement of locating device in breast using MRI guidance, first growth",1100.0,550.0,330.0,1769.88,32
CDM,9291044,"Placement of locating device in breast using MRI guidance, each additional growth",673.0,336.5,201.9,1769.88,32
CDM,9291045,Limited ultrasound scan of 1 breast,714.0,357.0,66.16,971.04,32
CDM,9291046,Complete ultrasound scan of 1 breast,1104.0,552.0,66.16,1501.44,32
CDM,9291047,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",114.0,57.0,34.2,155.04,28
CDM,9291048,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",114.0,57.0,34.2,155.04,28
CDM,9291049,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",181.0,90.5,54.3,246.16,28
CDM,9291051,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",230.0,115.0,69.0,312.8,28
CDM,9291052,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",230.0,115.0,69.0,312.8,28
CDM,9291053,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",181.0,90.5,54.3,246.16,28
CDM,9291054,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",181.0,90.5,54.3,246.16,28
CDM,9291055,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",121.0,60.5,36.3,164.56,28
CDM,9291057,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",241.0,120.5,72.3,327.76,28
CDM,9291058,"Placement of soft tissue locating device using X-ray, first growth",2176.0,1088.0,652.8,2959.36,30
CDM,9291061,Diagnostic mammography of 1 breast,596.0,298.0,59.94,810.56,32
CDM,9291062,Diagnostic mammography of both breasts,693.0,346.5,59.94,942.48,32
CDM,9291063,Screening mammography,621.0,310.5,59.94,844.56,32
CDM,9291065,Screening 3D breast mammography,280.0,140.0,23.83,380.8,32
CDM,9291066,3D breast mammography of 1 breast,190.0,95.0,59.94,1854.0,64
CDM,9291067,3D breast mammography of both breasts,226.0,113.0,59.94,1854.0,64
CDM,9291068,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",1159.0,579.5,347.7,1576.24,28
CDM,9291069,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",201.0,100.5,60.3,273.36,28
CDM,9291070,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",195.0,97.5,58.5,265.2,28
CDM,9291071,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",195.0,97.5,58.5,265.2,28
CDM,9291072,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",201.0,100.5,60.3,273.36,28
CDM,9291073,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",153.0,76.5,45.9,208.08,28
CDM,9291074,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",153.0,76.5,45.9,208.08,28
CDM,9291075,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",203.0,101.5,60.9,276.08,28
CDM,9291076,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",135.0,67.5,40.5,183.6,28
CDM,9291077,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",135.0,67.5,40.5,183.6,28
CDM,9291078,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",135.0,67.5,40.5,183.6,28
CDM,9291079,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",186.0,93.0,55.8,252.96,28
CDM,9291080,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",90.0,45.0,27.0,122.4,28
CDM,9291081,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",79.0,39.5,23.7,107.44,28
CDM,9291082,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",72.0,36.0,21.6,97.92,28
CDM,9291084,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",162.0,81.0,48.6,220.32,28
CDM,9291086,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (LOCAMETZ), 1 MILLICURIE",2123.0,1061.5,598.13,2887.28,27
CDM,9291088,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",3695.0,1847.5,789.56,5025.2,27
CDM,9301052,"GALLIUM GA-67 CITRATE, DIAGNOSTIC, PER MILLICURIE",186.0,93.0,37.47,252.96,28
CDM,9301069,"IODINE I-131 IOBENGUANE SULFATE, DIAGNOSTIC, PER 0.5 MILLICURIE",14228.0,7114.0,1572.47,19350.08,27
CDM,9301072,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",372.0,186.0,50.14,505.92,28
CDM,9301073,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",184.0,92.0,55.2,250.24,28
CDM,9301076,"TECHNETIUM TC-99M EXAMETAZIME, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",3109.0,1554.5,932.7,4228.24,27
CDM,9301078,"TECHNETIUM TC-99M SODIUM GLUCEPTATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIE",161.0,80.5,48.3,218.96,26
CDM,9301085,"TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE",562.0,281.0,168.6,764.32,28
CDM,9301088,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES",253.0,126.5,75.9,505.38,28
CDM,9301089,"IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE",135.0,67.5,39.72,531.39,31
CDM,9301093,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",339.0,169.5,101.7,461.04,28
CDM,9301094,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES",430.0,215.0,34.72,584.8,28
CDM,9301198,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",733.0,366.5,192.89,996.88,28
CDM,9301202,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",863.0,431.5,199.5,1173.68,28
CDM,9301203,Radioactive drug therapy by mouth,1932.0,966.0,91.54,2627.52,32
CDM,9301204,Radioactive drug therapy through a vein,2063.0,1031.5,88.32,2805.68,32
CDM,9301209,Calculation of radiation therapy dose,1080.0,540.0,63.63,1468.8,32
CDM,9301220,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",2241.0,1120.5,672.3,3047.76,27
CDM,9301224,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",1217.0,608.5,365.1,1655.12,28
CDM,9301225,"TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",230.0,115.0,69.0,312.8,28
CDM,9301226,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",258.0,129.0,77.4,1239.81,28
CDM,9301228,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",102.0,51.0,19.83,138.72,28
CDM,9301237,"Nuclear medicine study, 1 area",932.0,466.0,211.93,1267.52,32
CDM,9301241,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",101.0,50.5,30.3,137.36,28
CDM,9301242,"INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",4837.0,2418.5,1451.1,6578.32,27
CDM,9301243,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",84.0,42.0,25.2,114.24,28
CDM,9301245,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",258.0,129.0,77.4,1239.81,28
CDM,9301249,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER MILLICURIE",1226.0,613.0,287.13,1667.36,28
CDM,9301250,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",1988.0,994.0,596.4,2703.68,27
CDM,9301252,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",10191.0,5095.5,3057.3,13859.76,27
CDM,9301253,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",560.0,280.0,168.0,16409.66,31
CDM,9301255,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",1541.0,770.5,462.3,2095.76,26
CDM,9301256,"RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURIES",300.0,150.0,90.0,882.88,28
CDM,9301258,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",1541.0,770.5,462.3,2095.76,26
CDM,9301260,Nuclear medicine study of bone and/or joint limited area,1307.0,653.5,155.87,1777.52,32
CDM,9301266,"FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES",542.0,271.0,162.6,737.12,28
CDM,9301268,"IODINE I-131 IODINATED SERUM ALBUMIN, DIAGNOSTIC, PER 5 MICROCURIES",3736.0,1868.0,1120.8,5080.96,28
CDM,9301269,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC, 1 MILLICURIE",690.0,345.0,207.0,47865.64,31
CDM,9341007,"Sleep study, multiple trials",4860.0,2430.0,290.28,6609.6,32
CDM,9403651100,Mechanical separation of white blood cells from blood,4252.0,2126.0,1275.6,5782.72,32
CDM,9403651200,Mechanical separation of red blood cells from blood,4883.0,2441.5,1464.9,6640.88,32
CDM,9403651400,Mechanical separation of plasma from blood,6197.0,3098.5,1859.1,8427.92,32
CDM,9409604100,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",146.0,73.0,43.8,198.56,28
CDM,9409637200,Injection of drug or substance under skin or into muscle,233.0,116.5,58.14,316.88,32
CDM,9409637700,Application of on-body injector for under skin injection,263.0,131.5,58.14,357.68,32
CDM,9409652300,Irrigation of implanted venous access drug delivery device,374.0,187.0,58.14,508.64,32
CDM,9409918400,Treatment by lowering head or total body temperature in neonate,1800.0,900.0,540.0,2448.0,28
CDM,9441050,MRI scan of blood vessels of leg,3901.0,1950.5,617.13,5305.36,32
CDM,9441060,Test of neurological function during functional MRI,769.0,384.5,230.7,1045.84,32
CDM,9471002,Transfusion of blood or blood products,1304.0,652.0,391.2,1773.44,32
CDM,9481023,Needle biopsy of pancreas,3351.0,1675.5,905.56,4557.36,32
CDM,9481031,Simple change of bladder tube,772.0,386.0,108.16,1049.92,32
CDM,9481035,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",1476.0,738.0,442.8,2007.36,32
CDM,9491034,"CATHETER, DRAINAGE",150.0,75.0,45.0,204.0,28
CDM,9491040,"CATHETER, DRAINAGE",1884.0,942.0,565.2,2562.24,28
CDM,9491241,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",2.0,1.0,0.25,2.72,28
CDM,9491348,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",4470.0,2235.0,1341.0,6079.2,28
CDM,9491395,Injection for repair of abnormal muscle drainage tract,2750.0,1375.0,825.0,3740.0,32
CDM,9491396,Injection of drug or substance into artery,659.0,329.5,58.14,896.24,32
CDM,9491444,Other procedure on thigh or knee,6100.0,3050.0,317.61,8296.0,32
CDM,9491537,HB BARD MARGQUEE 12 GAUGE,345.0,172.5,86.25,227.7,16
CDM,9491539,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",257.0,128.5,77.1,349.52,28
CDM,9491552,Other procedure on abdomen,4442.0,2221.0,905.56,6041.12,32
CDM,9491554,"Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin",3709.0,1854.5,1112.7,5044.24,32
CDM,9491555,Insertion of stent to shunt arterial blood to deep vein of lower leg via catheter using imaging guidance,54728.0,27364.0,13425.43,74430.08,31
CDM,9491556,Calculation of radiation therapy dose,1080.0,540.0,63.63,1468.8,32
CDM,9491558,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",17732.0,8866.0,4624.13,24115.52,32
CDM,9491559,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",28078.0,14039.0,7754.24,38186.08,32
CDM,9491562,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES), WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",23100.0,11550.0,6930.0,31416.0,32
CDM,9491567,Creation of opening between artery and vein in arm with single access to both blood vessels,54252.0,27126.0,4416.11,73782.72,32
CDM,9491569,"Irreversible electroporation destruction of growths of internal organ, accessed through skin",25248.0,12624.0,4587.63,34337.28,30
CDM,9491574,Implantation of artificial valve between right upper and lower chambers of heart through catheter,7500.0,3750.0,2250.0,19194.56,30
CDM,9491577,Quantitative magnetic resonance analysis of tissue composition with diagnostic MRI examination,2958.0,1479.0,302.84,4022.88,31
CDM,9491594,Laser destruction of benign growth of thyroid using imaging guidance,4950.0,2475.0,1485.0,6732.0,32
CDM,9491607,Acoustic energy destruction of malignant liver tissue using imaging guidance,38235.0,19117.5,488.25,51999.6,31
CDM,9491619,"Quantitative magnetic resonance for analysis of tissue composition of multiple organs obtained with diagnostic MRI of same anatomy, with interpretation and report",2972.0,1486.0,302.84,4041.92,31
CDM,9491621,Other heart surgery procedure,2310.0,1155.0,693.0,3141.6,32
CDM,9491629,"ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD), INCLUDING ENDOSCOPY OR COLONOSCOPY, MUCOSAL CLOSURE, WHEN PERFORMED",10114.0,5057.0,2516.76,13755.04,32
CDM,980003,CT scan of heart with evaluation of blood vessel calcium,49.0,24.5,28.19,67.23,32
CDM,980004,HB CT LUNG SCREENING CASH/PROMO,135.0,67.5,40.5,81.0,2
CDM,980009,HB HI VS AAA ULTRASOUND ONLY,25.0,12.5,7.5,15.0,2
CDM,980013,HB VASCULAR SCREENING,25.0,12.5,7.5,15.0,2
CDM,9990000013,HB COSMETIC NASAL TELANGIECTASIA V BEAM,60.0,30.0,18.0,36.0,2
CDM,9990000014,HB COSMETIC PHOTOREJUVENATION V BEAM,200.0,100.0,60.0,120.0,2
CDM,9990000018,HB COSMETIC CHERRY ANGIOMA V BEAM,60.0,30.0,18.0,36.0,2
CDM,9990000028,HB NEW TINNITUS EVALUATION,110.0,55.0,33.0,66.0,2
CDM,9990000035,"HB SPOT TREATMENT (SK, SH, ETC), UP TO 5- ABLATIVE LASER, CONTOUR SPOT",100.0,50.0,30.0,60.0,2
CDM,9990000042,HB SKINPEN - MICRO NEEDLING PROEDURE FULL FACE 3 PACK,400.0,200.0,120.0,240.0,2
CDM,9990000048,HB COSMETIC FRAXEL LASER TREATMENT FOCAL AREA/ SCAR,200.0,100.0,60.0,120.0,2
CDM,9990000050,HB COSMETIC FRAXEL LASER TREATMENT FULL FACE,600.0,300.0,180.0,360.0,2
CDM,9990000057,HB TINNITUS LOW,30.0,15.0,9.0,18.0,2
CDM,99900002,HB AAA PROMO,25.0,12.5,7.5,15.0,2
CDM,RX-10001,"TEMOZOLOMIDE, ORAL, 5 MG",6.82,3.41,0.89,9.27,28
CDM,RX-10084,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",1.76,0.88,0.53,2.39,28
CDM,RX-10087,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",29.055,14.530000000000001,6.34,40.25,28
CDM,RX-10089,"CARDIOPLEGIC 16 MEQ K/1,000 ML",254.0,127.0,63.5,167.64,16
CDM,RX-10306,"INJECTION, METRONIDAZOLE, 10 MG",2.51,1.26,0.05,3.2,28
CDM,RX-10328,DIPHENOXYLATE-ATROP 2.5-0.025,11.63,5.82,2.91,7.68,16
CDM,RX-104209,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",10.48,5.24,0.15,227.67,28
CDM,RX-10469,"INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",3670.83,1835.42,694.74,4992.33,32
CDM,RX-104906,"INJECTION, EPINEPHRINE (BPI), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",224.6,112.3,1.83,314.55,28
CDM,RX-104909,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",142.58,71.29,3.58,193.91,28
CDM,RX-104978,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",6.26,3.13,0.18,8.52,28
CDM,RX-104988,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,630.885,315.445,6.44,776.21,16
CDM,RX-105130,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",3.09,1.55,0.15,4.2,28
CDM,RX-105462,"INJECTION, ECULIZUMAB, 2 MG",183.67000000000002,91.835,39.87,318.82,27
CDM,RX-105520,"Hepatitis B vaccine, adult dosage (3 dose schedule)",125.695,62.85,26.68,211.3,32
CDM,RX-105699,"INJECTION, ZOLEDRONIC ACID, 1 MG",222.48,111.24,8.38,1000.0,28
CDM,RX-105741,ETHYL CHLORIDE SPRAY,99.5,49.75,24.88,65.67,16
CDM,RX-105745,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,109.045,54.519999999999996,19.52,87.92,16
CDM,RX-105829,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",183.0,91.5,26.68,316.88,32
CDM,RX-10590004,"INJECTION, NATALIZUMAB, 1 MG",76.88,38.44,23.06,5897.78,31
CDM,RX-10590062,HDM FAMOTIDINE 20MG/5ML NS IV SIMPLE DSPN,56.65,28.33,14.16,37.39,16
CDM,RX-10590066,HDM FOSAPREPITANT 150MG/250ML NS IVPB SIMPLE DSPN,20.595,10.295,5.15,13.6,16
CDM,RX-10590067,HDM ONDANSETRON 16MG/58ML NS IVPB SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590068,HDM DEXAMETHASONE 4MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590069,HDM DEXAMETHASONE 8MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590070,HDM DEXAMETHASONE 10MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590071,HDM DEXAMETHASONE 12MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590072,HDM DEXAMETHASONE 20MG/52ML NS IVPB SIMPLE DSPN,20.6,10.3,5.15,13.6,16
CDM,RX-10590088,HDM IRON SUCROSE 200MG/110ML NS IVPB SIMPLE DSPN,501.945,250.975,19.22,611.82,16
CDM,RX-105954,SYMBICORT 80-4.5 MCG INHALER,782.75,391.38,195.69,516.62,16
CDM,RX-105955,SYMBICORT 160-4.5 MCG INHALER,782.75,391.38,195.69,516.62,16
CDM,RX-105973,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,6.86,3.43,1.72,4.53,16
CDM,RX-105977,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",215.17,107.58,26.68,316.88,32
CDM,RX-106003,SODIUM CHLORIDE 7 % FOR NEBULIZATION,11.92,5.96,3.11,7.52,16
CDM,RX-106562,RIVASTIGMINE 4.6 MG/24HR PATCH,23.8,11.9,5.95,15.71,16
CDM,RX-106563,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,24.27,12.13,6.07,16.02,16
CDM,RX-107010,"INJECTION, IFOSFAMIDE, 1 GRAM",319.82,159.91,40.99,434.95,28
CDM,RX-107011,"INJECTION, IFOSFAMIDE, 1 GRAM",319.82,159.91,40.99,434.95,28
CDM,RX-107511,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",121.03,60.52,30.26,79.88,16
CDM,RX-10879,"INJECTION, COSYNTROPIN, 0.25 MG",233.0,116.5,34.07,404.44,28
CDM,RX-10889,HYDRALAZINE 25 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-10913,ROCURONIUM 50 MG/5 ML VIAL,32.815,16.41,8.42,28.36,16
CDM,RX-109524,"INJECTION, LANREOTIDE, 1 MG",261.45500000000004,130.73000000000002,58.39,5897.78,31
CDM,RX-109525,"INJECTION, LANREOTIDE, (CIPLA), 1 MG",267.82,133.91,63.06,5897.78,31
CDM,RX-109628,"INJECTION, FAMOTIDINE, 0.25 MG",2.02,1.04,0.02,2.85,28
CDM,RX-1102,TROPICAMIDE 0.5 % EYE DROPS,84.83,42.415,20.67,57.42,16
CDM,RX-110359,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",38.144999999999996,19.07,0.68,52.53,28
CDM,RX-110360,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",12.725,6.365,0.68,25.5,28
CDM,RX-110589,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",104.36,52.18,26.62,128.16,32
CDM,RX-110743,"Haemophilus influenzae type b vaccine, PRP-T conjugate",122.15,61.07,26.68,178.23,32
CDM,RX-110878,"INJECTION, IRINOTECAN, 20 MG",33.28,16.64,2.95,56.13,28
CDM,RX-110917,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",44.9,22.45,2.21,61.06,27
CDM,RX-110918,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",33.16,16.58,2.21,45.1,27
CDM,RX-1111,"INJECTION, FUROSEMIDE, 1 MG",3.95,1.97,0.03,4.47,28
CDM,RX-111188,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",48.915,24.46,3.38,2382.19,31
CDM,RX-11158,AMLODIPINE BESYLATE 2.5 MG TAB,10.4,5.2,2.6,21.22,16
CDM,RX-112015,"Measles, mumps, and rubella vaccine",170.55,85.275,26.68,295.96,32
CDM,RX-112103,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",42.89,21.44,6.39,1677.59,31
CDM,RX-112287,"INJECTION, METHYLNALTREXONE, 0.1 MG",114.275,57.14,1.14,234.0,28
CDM,RX-112309,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",24.33,12.17,6.19,33.09,28
CDM,RX-112328,"INJECTION, REGADENOSON, 0.1 MG",129.865,64.935,4.42,324.96,28
CDM,RX-11272,TROPICAMIDE 1 % EYE DROPS,37.63,18.82,9.41,24.84,16
CDM,RX-11309,"AZATHIOPRINE, ORAL, 50 MG",14.305,7.15,0.1,27.2,28
CDM,RX-113107,"INJECTION, MILRINONE LACTATE, 5 MG",22.42,11.21,2.23,30.49,28
CDM,RX-113139,"INJECTION, FLUOROURACIL, 500 MG",39.765,19.885,3.2,83.04,28
CDM,RX-113140,"INJECTION, FLUOROURACIL, 500 MG",42.75,21.37,3.2,86.12,28
CDM,RX-113241,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",147.195,73.6,0.3,196.38,28
CDM,RX-113242,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",73.45,36.72,0.3,99.89,28
CDM,RX-113345,ACETIC ACID (BULK) 5 % LIQUID,31.7,15.85,7.93,20.92,16
CDM,RX-113372,"INJECTION, CYCLOSPORINE, 250 MG",261.0,130.5,78.3,354.96,28
CDM,RX-113514,"INJECTION, GADOXETATE DISODIUM, 1 ML",48.83,24.41,14.65,66.41,56
CDM,RX-113517,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",25.95,12.97,7.72,298.35,27
CDM,RX-113518,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",219.72,109.86,10.55,298.82,27
CDM,RX-113560,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,24.535,12.27,6.38,17.39,16
CDM,RX-113574,"VINCRISTINE SULFATE, 1 MG",66.03,33.015,13.45,248.32,28
CDM,RX-113575,"INJECTION, PANITUMUMAB, 10 MG",544.06,272.03,163.36,4737.06,31
CDM,RX-113580,"INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG",108.08,54.04,28.43,146.99,28
CDM,RX-11366,HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,103.0,51.5,25.75,67.98,16
CDM,RX-11396,MELATONIN 3 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-1141,FLUCONAZOLE 100 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-11427,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",19.35,9.675,2.56,31.8,28
CDM,RX-114397,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",71.92,35.96,4.59,97.81,28
CDM,RX-114517,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",161.25,80.63,48.38,219.31,28
CDM,RX-1146,ATORVASTATIN 40 MG TABLET,11.58,5.79,2.89,7.64,16
CDM,RX-114600,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",60.0,30.0,13.23,81.6,28
CDM,RX-114644,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",25.96,12.98,7.16,604.48,31
CDM,RX-114667,"INJECTION, DOPAMINE HCL, 40 MG",43.84,21.92,1.32,59.63,28
CDM,RX-114673,"INJECTION, DOPAMINE HCL, 40 MG",7.45,3.73,1.32,10.14,28
CDM,RX-114731,"INJECTION, NICARDIPINE, 0.1 MG",1.28,0.64,0.12,1.75,28
CDM,RX-114739,"INJECTION, CETUXIMAB, 10 MG",374.09000000000003,187.04500000000002,66.58,2382.19,31
CDM,RX-114740,"INJECTION, CETUXIMAB, 10 MG",208.06,104.03,62.42,2382.19,31
CDM,RX-114901,"INJECTION, PLERIXAFOR, 1 MG",226.96,113.48,6.81,5897.78,31
CDM,RX-11511,CLOPIDOGREL 75 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-115679,"INJECTION, DEGARELIX, 1 MG",272.375,136.19,7.34,705.84,31
CDM,RX-115696,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",104.025,52.015,12.47,250.41,31
CDM,RX-116307,"INJECTION, NITROGLYCERIN, 5 MG",25.52,12.76,2.51,34.7,28
CDM,RX-11720,GUAIFENESIN-DM 200-20 MG/10 ML,30.0,15.0,7.5,19.8,16
CDM,RX-117654,"INJECTION, CYTARABINE, 100 MG",600.8299999999999,300.41499999999996,1.39,859.06,28
CDM,RX-117684,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",8.67,2.925,0.59,250.41,31
CDM,RX-117882,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG",56.05,28.02,0.56,75.66,27
CDM,RX-118793,ROCURONIUM 50 MG/5 ML (10 MG/ML) INTRAVENOUS SYRINGE,64.53,32.27,16.13,42.59,16
CDM,RX-118936,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",29.425,14.715,9.56,604.48,31
CDM,RX-11930,AMLODIPINE BESYLATE 5 MG TAB,10.0,5.0,2.5,6.6,16
CDM,RX-11967,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",5.49,3.085,1.29,13.6,28
CDM,RX-119877,"INJECTION, TOCILIZUMAB, 1 MG",12.4,6.2,3.72,1286.64,31
CDM,RX-119878,"INJECTION, TOCILIZUMAB, 1 MG",33.19,16.59,9.26,1286.64,31
CDM,RX-119879,"INJECTION, TOCILIZUMAB, 1 MG",34.85,17.42,9.26,1286.64,31
CDM,RX-119891,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",73.68,36.84,0.27,98.36,28
CDM,RX-119892,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.44,0.72,0.27,1.95,28
CDM,RX-119893,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.42,0.71,0.27,1.93,28
CDM,RX-119894,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.42,0.71,0.27,1.93,28
CDM,RX-119928,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",12.62,6.31,3.79,9401.8,32
CDM,RX-120316,"INJECTION, ROMIDEPSIN, LYOPHILIZED, 0.1 MG",117.53,58.76,35.26,5897.78,31
CDM,RX-12039,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",343.51,171.75,87.58,467.17,31
CDM,RX-1209,MESALAMINE 4 GRAM/60 ML ENEMA,55.0,27.5,13.75,36.3,16
CDM,RX-120970,"SIROLIMUS, ORAL, 1 MG",25.65,12.83,1.6,34.89,28
CDM,RX-120998,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",46.23,23.12,14.8,91.11,28
CDM,RX-120999,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",64.59,32.295,20.23,155.92,28
CDM,RX-12108,ALLOPURINOL 100 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-121081,"EVEROLIMUS, ORAL, 0.25 MG",23.42,11.71,1.95,31.85,28
CDM,RX-121082,"EVEROLIMUS, ORAL, 0.25 MG",15.6,7.8,1.95,21.21,28
CDM,RX-12113,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",217.0,108.5,1.45,316.88,28
CDM,RX-12126,SODIUM BENZOATE (BULK) POWDER,23.0,11.5,5.75,15.18,16
CDM,RX-121294,"INJECTION, DENOSUMAB, 1 MG",105.975,52.989999999999995,22.93,1228.64,31
CDM,RX-121896,"INJECTION, AMIKACIN SULFATE, 100 MG",34.335,17.17,1.02,316.88,28
CDM,RX-121905,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",1.84,0.92,0.02,2.51,28
CDM,RX-121915,"INJECTION, CABAZITAXEL, 1 MG",783.77,391.885,228.14,5897.78,31
CDM,RX-121993,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",619.45,309.72,145.38,842.45,31
CDM,RX-122237,"INSTILLATION, HEXAMINOLEVULINATE HYDROCHLORIDE, 100 MG",3246.0,1623.0,973.8,4414.56,28
CDM,RX-122264,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",16.71,8.350000000000001,5.68,604.48,31
CDM,RX-12273,ENALAPRILAT 2.5 MG/2 ML VIAL,79.26,39.63,19.82,52.31,16
CDM,RX-12274,VALACYCLOVIR HCL 500 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-12298,"INJECTION, METHOTREXATE SODIUM, 50 MG",29.485,14.745000000000001,4.26,40.25,28
CDM,RX-123037,"INJECTION, DOCETAXEL, 1 MG",70.515,35.255,1.07,131.4,32
CDM,RX-123038,"INJECTION, DOCETAXEL, 1 MG",96.03,48.01,1.07,132.38,32
CDM,RX-123042,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,28.58,14.29,7.15,18.86,16
CDM,RX-123151,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",10.76,5.38,3.23,154.11,31
CDM,RX-123224,"INJECTION, FOSAPREPITANT, 1 MG",6.56,3.28,0.18,8.85,28
CDM,RX-123269,"INJECTION, DENOSUMAB, 1 MG",642.98,321.49,13.02,1228.64,31
CDM,RX-123316,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,161.76,80.88,40.44,106.76,16
CDM,RX-123317,BUPRENORPHINE 10 MCG/HR PATCH,183.43,91.72,45.86,121.07,16
CDM,RX-123318,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,290.34,145.17,72.58,191.62,16
CDM,RX-124099,TETRACAINE 0.5% STERI-UNIT SOL,53.28,26.64,13.32,35.16,16
CDM,RX-12413,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-124213,"INJECTION, TOPOTECAN, 0.1 MG",45.58,22.79,2.06,61.99,28
CDM,RX-124253,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.36,1.68,0.68,4.57,28
CDM,RX-124284,"SODIUM BICARBONATE 150 MEQ/1,000 ML IN DEXTROSE 5 % INTRAVENOUS",5.15,2.58,1.29,3.4,16
CDM,RX-12435,HYDROCODONE-ACETAMIN 10-325 MG,30.0,15.0,7.5,19.8,16
CDM,RX-125010,"INJECTION, IRON SUCROSE, 1 MG",3.3049999999999997,1.65,0.4,4.14,28
CDM,RX-125037,"INJECTION, IPILIMUMAB, 1 MG",358.54,179.27,107.56,9401.8,31
CDM,RX-125351,"INJECTION, EPINEPHRINE (ADRENALIN), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",15.695,7.85,2.28,23.38,28
CDM,RX-125582,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1398.5,699.25,281.79,1901.96,31
CDM,RX-125608,"INJECTION, BELATACEPT, 1 MG",14.505,7.25,4.42,1286.64,31
CDM,RX-12618,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",214.7,107.35,64.41,291.99,28
CDM,RX-126297,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",805.0,402.5,185.6,1400.8,31
CDM,RX-126300,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",31.9,15.95,2.52,43.38,28
CDM,RX-1267,CLOTRIMAZOLE 10 MG TROCHE,15.25,7.63,3.81,10.07,16
CDM,RX-126760,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",616.525,308.265,108.93,9401.8,31
CDM,RX-12733,TRAMADOL 50 MG TABLET,30.0,15.0,7.5,19.8,16
CDM,RX-12737,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",38.99,19.49,0.05,53.02,28
CDM,RX-12758,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",4.92,2.46,0.97,6.45,27
CDM,RX-127589,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",30.09,15.04,4.16,78.98,28
CDM,RX-127590,"INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML",2095.565,1047.7849999999999,69.9,5383.06,30
CDM,RX-12768,"INJECTION, DIGOXIN, UP TO 0.5 MG",49.83,24.915,12.0,80.55,28
CDM,RX-127812,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",457.32,228.66,5.92,621.96,28
CDM,RX-127906,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",6.54,3.27,0.58,9.1,28
CDM,RX-127959,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",53.71,26.85,13.43,35.45,16
CDM,RX-127979,DOCUSATE SODIUM 283 MG/5 ML ENEMA,19.0,9.5,4.75,12.54,16
CDM,RX-12851,ACETAMINOPHEN 500 MG TABLET,11.469999999999999,5.73,1.53,7.56,16
CDM,RX-129194,LIDOCAINE 5% OINTMENT,927.0,463.5,231.75,611.82,16
CDM,RX-129359,"INJECTION, FENTANYL CITRATE, 0.1 MG",80.84,40.42,1.96,109.94,28
CDM,RX-13004,TRIAMCINOLONE 0.1% CREAM,20.0,10.0,5.0,13.2,16
CDM,RX-1302,DIPHENHYDRAMINE 12.5MG/5ML CUP,14.65,7.325,2.33,12.56,16
CDM,RX-130222,"INJECTION, GLUCARPIDASE, 10 UNITS",1065.77,532.88,319.73,20978.86,31
CDM,RX-130227,"INJECTION, MITOMYCIN, 5 MG",1120.5,560.25,43.07,1523.88,31
CDM,RX-130852,"INJECTION, PERTUZUMAB, 1 MG",40.735,20.365000000000002,9.97,4737.06,31
CDM,RX-131774,"INJECTION, DOCETAXEL, 1 MG",97.34,48.67,1.07,132.38,32
CDM,RX-131872,"INJECTION, CARFILZOMIB, 1 MG",134.555,67.275,30.75,1677.59,31
CDM,RX-1320,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",44.855000000000004,22.425,13.98,63.19,28
CDM,RX-13215,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",67.5,33.75,0.54,304.55,27
CDM,RX-1323,SILVER SULFADIAZINE 1 % TOPICAL CREAM,35.0,17.5,8.75,23.1,16
CDM,RX-1324,METFORMIN 500 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-13268,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",63.27,31.64,7.24,404.26,28
CDM,RX-13309,"INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG",224.585,112.295,65.79,296.04,28
CDM,RX-133852,ELIQUIS 5 MG TABLET,32.5,16.25,8.13,21.45,16
CDM,RX-134981,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",143.17,71.59,42.95,4737.06,31
CDM,RX-134982,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",143.17,71.59,42.95,4737.06,31
CDM,RX-13503,"INJECTION, CEFOXITIN SODIUM, 1 GM",56.99,28.49,7.82,77.5,28
CDM,RX-135378,PRECEDEX 200 MCG/50 ML BOTTLE,12.02,6.01,3.0,7.93,16
CDM,RX-13546,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",1.5899999999999999,0.79,0.02,2.21,28
CDM,RX-13601,"5% DEXTROSE IN LACTATED RINGERS INFUSION, UP TO 1000 CC",101.64,50.82,8.14,138.23,28
CDM,RX-13640,"INJECTION, HYDROMORPHONE, 0.1 MG",66.0,33.0,0.09,89.76,28
CDM,RX-137006,"INJECTION, ZOLEDRONIC ACID, 1 MG",1269.99,635.0,8.38,1727.19,28
CDM,RX-137137,INTRAUTERINE COPPER CONTRACEPTIVE (PARAGARD),2754.76,1377.38,121.68,4841.6,32
CDM,RX-137198,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",98.385,49.190000000000005,15.51,1677.59,31
CDM,RX-13773,FLUORESCEIN 1 MG EYE STRIPS,10.15,5.08,2.54,6.7,16
CDM,RX-13783,SYNTHROID 25 MCG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-137909,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,249.95,124.97,62.49,164.97,16
CDM,RX-138489,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",66.0,33.0,0.23,89.76,28
CDM,RX-138514,"INJECTION, OBINUTUZUMAB, 10 MG",190.55,95.28,57.17,5897.78,31
CDM,RX-1396,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,128.57,64.285,8.03,148.5,16
CDM,RX-139759,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",20.0,10.0,5.0,13.2,16
CDM,RX-139857,"HYALURONAN OR DERIVATIVE, MONOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",4236.86,2118.43,570.27,5762.12,31
CDM,RX-139921,"INJECTION, RAMUCIRUMAB, 5 MG",125.91999999999999,62.96,37.82,5897.78,31
CDM,RX-140368,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",10.93,5.46,3.0,14.86,28
CDM,RX-141181,"HISTRELIN IMPLANT (SUPPRELIN LA), 50 MG",51866.0,25933.0,88.32,140780.4,31
CDM,RX-14122,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",148.61,74.3,33.26,202.11,28
CDM,RX-14156,Poliovirus vaccine,124.83,62.42,26.68,218.47,32
CDM,RX-14185,POTASSIUM CL 10% (20 MEQ/15ML),16.1,8.05,4.03,10.63,16
CDM,RX-141929,SPIRIVA RESPIMAT 2.5 MCG INH,82.06,41.03,20.52,54.16,16
CDM,RX-142033,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",66.0,33.0,5.02,89.76,28
CDM,RX-142160,"INJECTION, VASOPRESSIN, 1 UNIT",5.94,2.97,0.87,8.07,28
CDM,RX-142625,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",713.625,356.815,38.9,7389.48,32
CDM,RX-142639,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",28.88,14.44,7.22,19.06,16
CDM,RX-142641,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",12.36,6.18,3.09,8.16,16
CDM,RX-142749,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",759.18,379.59,56.4,1032.48,32
CDM,RX-142814,"INJECTION, NIVOLUMAB, 1 MG",95.43,47.715,20.17,5897.78,31
CDM,RX-142905,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",326.125,163.065,91.35,2382.19,31
CDM,RX-142938,"INJECTION, PEMBROLIZUMAB, 1 MG",141.37,76.765,42.41,9401.8,31
CDM,RX-142983,PRECEDEX 80 MCG/20 ML VIAL,98.31,49.16,24.58,64.88,16
CDM,RX-14342,LEVOTHYROXINE 75 MCG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-143516,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",199.05,99.52,59.67,2382.19,31
CDM,RX-143517,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",249.005,124.505,61.58,161.84,16
CDM,RX-14370,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.825,26.415,8.32,142.13,16
CDM,RX-143811,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",240.82,120.41,64.12,5897.78,31
CDM,RX-143812,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",226.515,113.25999999999999,4.66,5897.78,31
CDM,RX-143813,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",151.94,75.97,45.58,5897.78,31
CDM,RX-143821,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",291.69,145.85,87.51,396.7,31
CDM,RX-143825,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",149.0,74.5,36.0,860.63,32
CDM,RX-143826,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",173.995,87.0,36.0,349.64,32
CDM,RX-143879,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",1868.81,934.41,380.51,1991.74,32
CDM,RX-14415,"DEXAMETHASONE, ORAL, 0.25 MG",13.62,6.81,0.02,18.52,28
CDM,RX-144174,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",2.4050000000000002,1.205,0.58,314.55,31
CDM,RX-144175,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",5.42,2.705,0.58,316.88,31
CDM,RX-1443,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",2049.68,1024.84,120.64,2787.56,31
CDM,RX-144581,"INJECTION, CANGRELOR, 1 MG",41.2,20.6,12.36,604.48,31
CDM,RX-1448,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,650.03,325.02,162.51,429.02,16
CDM,RX-14502,"INJECTION, CYTARABINE, 100 MG",570.0,285.0,1.39,1035.0,28
CDM,RX-145054,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",1.9,0.95,0.57,3.09,28
CDM,RX-145055,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",1.03,0.51,0.31,3.09,28
CDM,RX-145251,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",59.7,29.85,17.91,81.2,28
CDM,RX-14535,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",4.29,2.14,0.25,5.83,28
CDM,RX-1459,HYDRALAZINE 10 MG TABLET,10.055,5.029999999999999,2.5,6.6,16
CDM,RX-145915,"INJECTION, TRABECTEDIN, 0.1 MG",1269.005,634.5,362.75,5897.78,32
CDM,RX-146018,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",14.76,7.38,4.43,1677.59,31
CDM,RX-146019,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",7.34,3.67,2.2,1677.59,31
CDM,RX-146020,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",16.01,8.01,4.8,1677.59,31
CDM,RX-146118,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",139.885,69.945,58.97,4737.06,31
CDM,RX-146139,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",168.92,84.46,50.68,5897.78,31
CDM,RX-146140,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",275.66,137.83,82.7,5897.78,31
CDM,RX-146409,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,37.93,18.96,9.48,25.03,16
CDM,RX-146410,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,43.75,21.87,10.94,28.87,16
CDM,RX-146455,"INJECTION, MEPOLIZUMAB, 1 MG",141.54500000000002,70.77000000000001,20.61,2382.19,31
CDM,RX-146469,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",5.89,2.94,1.77,8.01,28
CDM,RX-146469,"INJECTION, CEFAZOLIN SODIUM, 500 MG",40.065,20.035,1.37,56.27,28
CDM,RX-14656,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",2.93,1.47,0.54,1.94,28
CDM,RX-146812,BRIDION 500 MG/5 ML VIAL,558.895,279.445,91.99,494.9,16
CDM,RX-14690,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",12.594999999999999,6.295,0.2,20.4,28
CDM,RX-14691,CYCLOPENTOLATE 1 % EYE DROPS,52.13,26.06,13.03,34.41,16
CDM,RX-14764,UNCLASSIFIED DRUGS,23.4,11.7,7.02,31.82,26
CDM,RX-14788,Rabies immune globulin for injection beneath the skin and/or into muscle,149.0,74.5,39.24,1677.59,31
CDM,RX-147958,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,45.42,22.71,11.35,29.98,16
CDM,RX-14857,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",26.57,13.28,2.23,36.13,28
CDM,RX-14863,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",19.0,9.5,2.62,25.84,28
CDM,RX-14869,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",109.045,54.52,0.12,292.95,28
CDM,RX-149078,"INJECTION, ATEZOLIZUMAB, 10 MG",335.53499999999997,167.77,66.13,9401.8,31
CDM,RX-149217,"INJECTION, CARFILZOMIB, 1 MG",118.45,59.23,35.54,1677.59,31
CDM,RX-150115,PROVAYBLUE 50 MG/10 ML AMPULE,938.8799999999999,469.43999999999994,201.2,736.33,16
CDM,RX-150244,"USTEKINUMAB, FOR INTRAVENOUS INJECTION, 1 MG",70.175,35.09,14.6,4737.06,31
CDM,RX-15030,"INJECTION, CARMUSTINE, 100 MG",1063.92,531.96,319.18,2382.19,31
CDM,RX-150406,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",221.83,110.91,39.96,1286.64,31
CDM,RX-151058,"INJECTION, NUSINERSEN, 0.1 MG",1920.53,960.26,576.16,28568.47,31
CDM,RX-15110,"INJECTION, NITROGLYCERIN, 5 MG",14.27,7.14,2.51,19.41,28
CDM,RX-15227,"TACROLIMUS, PARENTERAL, 5 MG",126.78,63.39,38.04,433.04,31
CDM,RX-152334,"INJECTION, AVELUMAB, 10 MG",278.84,139.42,83.65,5897.78,31
CDM,RX-152349,"INJECTION, OCRELIZUMAB, 1 MG",202.42,101.21,40.56,28568.47,31
CDM,RX-152700,"INJECTION, THIOTEPA, NOT OTHERWISE SPECIFIED, 1 MG",311.35,155.68,14.62,423.44,27
CDM,RX-15286,CAFFEINE-SOD BENZOAT 250 MG/ML,103.71,51.85,25.93,68.45,16
CDM,RX-15299,"INJECTION, FOLIC ACID, 0.1 MG",223.0,111.5,0.08,303.75,28
CDM,RX-15308,MELPHALAN HCL 50 MG INTRAVENOUS POWDER FOR SOLUTION,1161.22,580.61,290.31,766.41,16
CDM,RX-15327,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,5.55,2.78,1.39,3.67,16
CDM,RX-153320,"INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG",362.45,181.23,108.74,2382.19,31
CDM,RX-153388,"INJECTION, DURVALUMAB, 10 MG",426.9,213.45,77.4,2382.19,31
CDM,RX-15339,SODIUM CHLORIDE 0.9% IRRIG.,101.87,50.93,25.47,67.23,16
CDM,RX-153483,"INJECTION, CERLIPONASE ALFA, 1 MG",199.13,99.57,59.74,20978.86,31
CDM,RX-15351,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",217.0,108.5,35.24,292.95,28
CDM,RX-153512,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",722.55,361.27,216.76,5897.78,31
CDM,RX-15378,ALENDRONATE 35 MG TABLET,75.0,37.5,18.75,49.5,16
CDM,RX-153845,"INJECTION, HEMIN, 1 MG",79.59,39.79,23.88,4737.06,31
CDM,RX-154418,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",6907.29,3453.65,1926.1,20978.86,31
CDM,RX-154458,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",1359.04,679.52,396.28,5897.78,31
CDM,RX-154629,"INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG (20MG)",5.06,2.53,1.52,154.11,31
CDM,RX-154638,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",251.18,125.59,39.34,1286.64,31
CDM,RX-15480,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",81.17,40.58,11.4,110.39,28
CDM,RX-154911,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",2961420.0,1480710.0,56281.85,4027531.2,29
CDM,RX-154935,Shingles vaccine for injection into muscle,416.855,208.43,38.9,962.65,30
CDM,RX-155146,"HYALURONAN OR DERIVATIVE, DUROLANE, FOR INTRA-ARTICULAR INJECTION, 1 MG",64.89,32.45,10.76,604.48,31
CDM,RX-155593,"INJECTION, PALONOSETRON HCL, 25 MCG",115.62,57.81,0.58,157.24,28
CDM,RX-155767,R.E.C.K.(ROPIV-EPI-CLON-KETOR),191.43,95.72,47.86,126.35,16
CDM,RX-155831,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",712.5,356.25,213.75,47865.64,31
CDM,RX-156266,STERILE TALC 4 GRAM INTRAPLEURAL SUSPENSION,484.67,242.33,121.17,319.88,16
CDM,RX-156576,"INJECTION, GANCICLOVIR SODIUM, 500 MG",111.84,55.92,33.55,152.1,28
CDM,RX-15688,AMPICILLIN 250 MG SOLUTION FOR INJECTION,56.0,28.0,14.0,36.96,16
CDM,RX-156897,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",122.93,61.465,0.75,316.88,32
CDM,RX-156898,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",8.49,4.24,0.75,128.98,32
CDM,RX-156899,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",217.0,108.5,0.75,308.18,32
CDM,RX-156900,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",40.9,20.45,0.75,295.12,32
CDM,RX-156917,LOKELMA 10 GRAM POWDER PACKET,30.0,15.0,7.5,19.8,16
CDM,RX-157249,"INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG",377.88,188.94,67.6,1677.59,31
CDM,RX-157313,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA INITIO), 1 MG",14.77,7.39,4.43,1286.64,31
CDM,RX-157331,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,2524.33,1262.165,772.11,1939.55,16
CDM,RX-15737,"INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG",217.0,108.5,0.07,295.12,28
CDM,RX-157735,"INJECTION, CARFILZOMIB, 1 MG",139.3,69.65,41.79,1677.59,31
CDM,RX-157779,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",522.525,261.265,0.46,1104.39,31
CDM,RX-157780,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",113.855,56.925,0.46,306.0,31
CDM,RX-158188,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.21,0.6,0.08,1.64,28
CDM,RX-158256,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",89.78,44.89,28.25,5897.78,31
CDM,RX-15826,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",355.86,177.93,87.58,490.28,31
CDM,RX-15867,SYNTHROID 88 MCG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-15886,ALPRAZOLAM 0.5 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-158869,"INJECTION, OMALIZUMAB, 5 MG",120.46000000000001,60.230000000000004,4.67,1677.59,31
CDM,RX-158903,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",230.71,115.36,73.1,2382.19,31
CDM,RX-158972,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",1.52,0.76,0.05,2.07,28
CDM,RX-159245,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",328.295,164.15,49.75,2382.19,31
CDM,RX-159772,"INJECTION, CALASPARGASE PEGOL-MKNL, 10 UNITS",265.745,132.875,66.01,9401.8,31
CDM,RX-15979,"INJECTION, FLUPHENAZINE HCL, 1.25 MG",20.05,10.03,6.02,27.27,28
CDM,RX-15983,PROPRANOLOL 10 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-160144,ARGININE 25 MG-LYSINE 25MG/ML IN STERILE WATER INTRAVENOUS SOLUTION,957.9,478.95,239.48,632.21,16
CDM,RX-160173,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",2.74,1.37,0.21,3.73,28
CDM,RX-160174,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",1.95,0.98,0.21,2.65,28
CDM,RX-16021,STERILE WATER FOR IRRIGATION,96.72,48.36,24.18,63.84,16
CDM,RX-16044,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",25.68,12.84,0.76,77.71,28
CDM,RX-160614,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",1.51,0.75,0.21,2.05,28
CDM,RX-160669,"INJECTION, ATEZOLIZUMAB, 10 MG",221.92000000000002,110.96000000000001,66.56,9401.8,31
CDM,RX-160688,"INJECTION, TRASTUZUMAB, 10 MG AND HYALURONIDASE-OYSK",388.745,194.375,92.46,4737.06,31
CDM,RX-160693,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",299.39,149.69,13.55,2382.19,31
CDM,RX-161202,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",45.32,22.66,13.6,1286.64,31
CDM,RX-161207,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",88.42,44.21,19.51,1286.64,31
CDM,RX-16124,"INJECTION, THIAMINE HCL, 100 MG",85.45,42.72,2.99,242.32,28
CDM,RX-161246,"INJECTION, LEVOTHYROXINE SODIUM (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0650, 10 MCG",26.83,13.41,8.05,36.48,27
CDM,RX-161720,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",272.53,136.265,21.9,2382.19,31
CDM,RX-161937,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",398.055,199.02499999999998,119.65,9401.8,31
CDM,RX-161959,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",366.57,183.28,84.88,1677.59,31
CDM,RX-16236,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",226.935,113.47,69.21,314.55,28
CDM,RX-16345,HYDROMORPHONE 2 MG TABLET,30.0,15.0,7.5,19.8,16
CDM,RX-16354,ALPRAZOLAM 0.25 MG TABLET,12.01,6.0,2.5,12.47,16
CDM,RX-164569,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",227.745,113.875,33.04,9401.8,31
CDM,RX-164570,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",226.33,114.0,38.28,9401.8,31
CDM,RX-164598,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",437.01,218.51,131.1,1286.64,31
CDM,RX-164611,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",126.16499999999999,63.084999999999994,7.82,308.95,27
CDM,RX-164634,"INJECTION, GIVOSIRAN, 0.5 MG",289.265,144.63,67.16,28568.47,31
CDM,RX-164646,"INJECTION, CEFIDEROCOL, 10 MG",5.26,2.63,1.58,154.11,31
CDM,RX-16498,FLEET MINERAL OIL ENEMA,16.63,8.32,4.16,10.98,16
CDM,RX-165127,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",220.235,110.11500000000001,39.29,604.48,31
CDM,RX-165181,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",88.465,44.230000000000004,23.74,5897.78,31
CDM,RX-165182,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",101.57,50.785,29.34,5897.78,31
CDM,RX-165186,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",85.18,42.59,25.56,2382.19,31
CDM,RX-16550,KLOR-CON M20 TABLET,9.245000000000001,4.62,1.43,8.42,16
CDM,RX-16554,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",76.32,38.16,13.23,103.79,28
CDM,RX-16588,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.88,2.94,0.35,27.2,28
CDM,RX-165977,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",58.73,29.37,17.62,1286.64,31
CDM,RX-166006,"INJECTION, ISATUXIMAB-IRFC, 10 MG",241.395,120.695,72.31,4737.06,31
CDM,RX-16603,FAMOTIDINE 20 MG TABLET,15.555,7.78,3.71,12.38,16
CDM,RX-166319,"INJECTION, REMDESIVIR, 1 MG",14.07,7.035,4.21,604.48,31
CDM,RX-166718,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",103.63499999999999,51.815,31.09,1228.64,31
CDM,RX-166723,"MITOMYCIN PYELOCALYCEAL INSTILLATION, 1 MG",1219.01,609.5,365.7,20978.86,31
CDM,RX-16683,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",47.05,23.53,6.34,63.99,28
CDM,RX-166863,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",3.78,1.89,0.21,5.14,28
CDM,RX-166865,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",2.07,1.04,0.21,2.82,28
CDM,RX-166882,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",3.39,1.69,0.21,4.61,28
CDM,RX-167006,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",645.375,322.685,49.93,4737.06,31
CDM,RX-16729,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",57.010000000000005,28.505000000000003,1.17,238.28,28
CDM,RX-167448,"INJECTION, INEBILIZUMAB-CDON, 1 MG",1619.16,809.58,485.75,20978.86,31
CDM,RX-167453,"INJECTION, LURBINECTEDIN, 0.1 MG",614.565,307.28,184.49,4737.06,31
CDM,RX-16747,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-167494,UNCLASSIFIED BIOLOGICS,541.77,270.89,162.53,736.81,26
CDM,RX-167518,"INJECTION, PERTUZUMAB, TRASTUZUMAB, AND HYALURONIDASE-ZZXF, PER 10 MG",487.38,243.69,78.53,4737.06,31
CDM,RX-167519,"INJECTION, PERTUZUMAB, TRASTUZUMAB, AND HYALURONIDASE-ZZXF, PER 10 MG",643.29,321.64,78.53,4737.06,31
CDM,RX-167871,"INJECTION, TAFASITAMAB-CXIX, 2 MG",50.305,25.15,15.07,4737.06,31
CDM,RX-16798,SUFENTANIL 50 MCG/ML VIAL,52.81,26.4,13.2,34.85,16
CDM,RX-168220,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",413.18,206.59,123.95,9401.8,31
CDM,RX-16832,"SIROLIMUS, ORAL, 1 MG",46.68,23.34,1.6,63.49,28
CDM,RX-168428,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",659.61,329.81,197.88,28568.47,31
CDM,RX-168730,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",132.31,66.155,0.75,316.88,32
CDM,RX-16900,LORAZEPAM 0.5 MG TABLET,18.564999999999998,9.285,4.8,14.61,16
CDM,RX-169017,"INJECTION, MARGETUXIMAB-CMKB, 5 MG",128.36,64.18,38.51,4737.06,31
CDM,RX-16910,METOCLOPRAMIDE 5 MG TABLET,12.36,6.18,3.09,8.16,16
CDM,RX-169635,"INJECTION, TRILACICLIB, 1MG",17.51,8.76,5.25,1286.64,31
CDM,RX-169660,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",299.01,149.51,13.55,2382.19,31
CDM,RX-17018,CALCIUM CHLORIDE 10% VIAL,55.07,27.54,13.77,36.35,16
CDM,RX-170286,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",5151.63,2575.815,118.83,20244.71,31
CDM,RX-170425,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",654.86,327.43,196.46,20978.86,31
CDM,RX-170433,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",826.3050000000001,413.155,210.18,9401.8,31
CDM,RX-170802,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",74.25,37.125,18.46,5897.78,31
CDM,RX-1710,"INJECTION, DILTIAZEM HYDROCHLORIDE, 0.5 MG",25.18,12.594999999999999,0.05,66.98,28
CDM,RX-171136,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",123.78,61.89,37.13,586.08,32
CDM,RX-171227,"INJECTION, ASPARAGINASE, RECOMBINANT, (RYLAZE), 0.1 MG",200.82999999999998,100.41499999999999,65.1,20978.86,31
CDM,RX-17126,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,5.76,2.88,1.44,3.8,16
CDM,RX-171486,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",41.805,20.905,11.59,2382.19,31
CDM,RX-171511,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",65.17,32.59,19.55,28568.47,31
CDM,RX-17158,MILK OF MAGNESIA SUSPENSION,20.0,10.0,5.0,13.2,16
CDM,RX-1716,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1.73,0.87,0.74,7.02,27
CDM,RX-171953,"INJECTION, TISOTUMAB VEDOTIN-TFTV, 1 MG",544.75,272.37,160.27,20978.86,31
CDM,RX-172576,"INJECTION, SIROLIMUS PROTEIN-BOUND PARTICLES, 1 MG",274.86,137.43,82.46,9401.8,31
CDM,RX-172713,"INJECTION, INCLISIRAN, 1 MG",40.1,20.05,12.03,2382.19,31
CDM,RX-172812,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",116.56,58.28,2.96,2382.19,31
CDM,RX-173291,"INJECTION, VASOPRESSIN, 1 UNIT",13.03,6.52,0.87,17.73,28
CDM,RX-1733,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",68.25,34.12,8.15,92.81,28
CDM,RX-173351,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",220.765,110.38,0.55,303.11,31
CDM,RX-173352,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",217.0,108.5,0.39,233.0,31
CDM,RX-17338,FENTANYL 100 MCG/HR PATCH,277.85,138.925,30.06,286.05,16
CDM,RX-173659,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",528.94,264.47,158.68,28568.47,31
CDM,RX-17423,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",7.43,3.71,0.2,10.1,28
CDM,RX-17439,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",9273.99,4636.99,2782.2,12612.62,31
CDM,RX-17453,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",43.0,21.5,5.02,89.76,28
CDM,RX-17460,"SIROLIMUS, ORAL, 1 MG",31.38,15.69,1.6,42.68,28
CDM,RX-174682,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",60.599999999999994,30.299999999999997,16.94,5897.78,31
CDM,RX-174836,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",230.595,115.3,62.28,20978.86,31
CDM,RX-17502,"DACARBAZINE, 100 MG",64.17500000000001,32.085,6.8,86.56,28
CDM,RX-17516,"METHOTREXATE; ORAL, 2.5 MG",20.31,10.16,0.25,27.62,28
CDM,RX-1752,UNCLASSIFIED DRUGS,233.0,116.5,69.9,316.88,26
CDM,RX-175361,INDOMETHACIN 100 MG RECTAL SUPPOSITORY,775.0,387.5,193.75,511.5,16
CDM,RX-175766,TERLIPRESSIN 0.85 MG INTRAVENOUS POWDER FOR SOLUTION,2159.81,1079.9,539.95,1425.47,16
CDM,RX-17581,LIDOCAINE HCL 4% SOLUTION,87.55,43.77,21.89,57.78,16
CDM,RX-176239,"INJECTION, CEFAZOLIN SODIUM, 500 MG",8.42,4.21,1.37,12.1,28
CDM,RX-176241,"INJECTION, GADOPICLENOL, 1 ML",17.79,8.9,5.33,42.62,28
CDM,RX-176277,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",482.04,241.02,144.61,5897.78,31
CDM,RX-176282,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",340.2,285.0,35.0,4737.06,31
CDM,RX-176283,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",109.39,54.69,34.96,4737.06,31
CDM,RX-176561,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",144843.75,72421.88,26951.36,196987.5,31
CDM,RX-176618,"INJECTION, UBLITUXIMAB-XIIY, 1MG",238.33,119.17,71.5,20978.86,31
CDM,RX-176923,"INJECTION, LECANEMAB-IRMB, 1 MG",4.75,2.38,1.43,736.42,31
CDM,RX-1771,Skin test for tuberculosis,76.0,38.0,10.2,103.36,32
CDM,RX-17743,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",9.030000000000001,4.52,0.2,22.51,28
CDM,RX-17754,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",526.065,263.03,69.9,1105.82,31
CDM,RX-178043,"INJECTION, TOFERSEN, 1 MG",439.71,219.86,131.91,598.01,27
CDM,RX-178297,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",589.38,294.695,26.68,1433.19,32
CDM,RX-178407,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",375.73,187.86,61.12,755.78,27
CDM,RX-178408,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",190.86,95.43,42.72,431.23,27
CDM,RX-178862,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",11069.725,5534.865,3799.94,17226.38,27
CDM,RX-17900,TAMSULOSIN 0.4 MG CAPSULE,20.0,10.0,5.0,13.2,16
CDM,RX-179199,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
CDM,RX-179200,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
CDM,RX-17926,LINEZOLID 600 MG TABLET,900.75,450.38,225.19,594.5,16
CDM,RX-179494,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",230.395,33.34,20.0,659.91,27
CDM,RX-179495,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",161.44,80.72,19.7,969.68,27
CDM,RX-180320,"INJECTION, MIRIKIZUMAB-MRKZ, 1 MG",118.57,59.29,35.57,161.26,27
CDM,RX-181172,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",767.3399999999999,383.66999999999996,114.96,2382.19,31
CDM,RX-18168,TRAZODONE 100 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-18243,"INJECTION, DOXYCYCLINE HYCLATE, 1 MG",33.915,16.96,0.17,90.11,28
CDM,RX-18244,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",32.04,16.02,2.19,65.36,28
CDM,RX-182602,"INJECTION, TARLATAMAB-DLLE, 1 MG",5859.0,2929.5,1668.6,8310.6,27
CDM,RX-182603,"INJECTION, TARLATAMAB-DLLE, 1 MG",7500.0,3750.0,2250.0,10200.0,27
CDM,RX-182918,"INJECTION, APREPITANT (APONVIE), 1 MG",7.16,3.58,2.91,9.74,20
CDM,RX-182933,"INJECTION, IMETELSTAT, 1 MG",212.20999999999998,106.10499999999999,73.45,11256.4,27
CDM,RX-182935,"INJECTION, IMETELSTAT, 1 MG",198.195,99.095,47.67,387.83,27
CDM,RX-18313,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",85.0,42.5,10.23,115.6,28
CDM,RX-183193,"INJECTION, DONANEMAB-AZBT, 2 MG",14.74,7.37,4.42,20.05,27
CDM,RX-183516,"INJECTION, AXATILIMAB-CSFR, 0.1 MG",267.16,133.58,80.15,363.34,27
CDM,RX-18358,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",5.16,2.58,0.02,7.02,28
CDM,RX-183797,"INJECTION, GUSELKUMAB, 1 MG",257.2,128.6,77.16,9401.8,31
CDM,RX-18419,"INJECTION, ETOPOSIDE, 10 MG",17.46,8.73,1.72,24.35,28
CDM,RX-18495,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",43.545,21.77,3.48,93.77,28
CDM,RX-18591,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",146.06,73.03,6.85,360.55,31
CDM,RX-18618,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",435.82,217.91,5.92,588.35,28
CDM,RX-1866,METHOXSALEN 20 MCG/ML INJECTION SOLUTION,329.70000000000005,164.85000000000002,56.7,285.52,16
CDM,RX-18739,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",540.0450000000001,270.02,37.98,1274.24,28
CDM,RX-18778,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,1048.75,524.38,262.19,692.18,16
CDM,RX-18810,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",22.13,11.06,1.8,45.37,28
CDM,RX-18825,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,261.63,130.82,65.41,172.68,16
CDM,RX-18830,SODIUM BICARB 650 MG TABLET,34.015,17.005,2.88,37.28,16
CDM,RX-18837,"INJECTION, FOMEPIZOLE, 15 MG",122.4,61.2,10.61,250.41,31
CDM,RX-19057,ETHAMBUTOL 400 MG TABLET,8.63,4.31,2.16,5.69,16
CDM,RX-19145,PROVISC 10 MG/ML DISP SYRNG,918.68,459.34,229.67,606.33,16
CDM,RX-19160,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",9.65,4.83,0.94,13.13,28
CDM,RX-19332,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",64.0,32.0,5.69,87.04,28
CDM,RX-19455,"DEXAMETHASONE, ORAL, 0.25 MG",1.55,0.77,0.02,3.4,28
CDM,RX-19522,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",12.98,6.49,1.22,219.29,28
CDM,RX-19552,"INJECTION, INSULIN, PER 5 UNITS",3.52,1.76,0.87,5.41,28
CDM,RX-19603,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",116.7,58.35,35.01,158.71,32
CDM,RX-19615,SEVOFLURANE 99.97 % INHALATION LIQUID,220.77,110.38,55.19,145.7,16
CDM,RX-19647,SYNTHROID 50 MCG TABLET,16.88,8.44,4.22,11.14,16
CDM,RX-19697,BISACODYL 10 MG SUPPOSITORY,10.0,5.0,2.5,6.6,16
CDM,RX-19716,"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",170.64,85.32,32.48,153.78,16
CDM,RX-19745,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",3.54,1.77,0.02,4.82,28
CDM,RX-19774,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),35.985,17.990000000000002,2.16,69.16,28
CDM,RX-19775,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",13.23,6.615,1.8,21.93,28
CDM,RX-19854,PANTOPRAZOLE SOD DR 40 MG TAB,58.595,29.3,14.0,40.39,16
CDM,RX-19855,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.27,0.64,0.27,1.73,28
CDM,RX-19894,"INJECTION, OXYTOCIN, UP TO 10 UNITS",217.0,108.5,4.44,316.88,28
CDM,RX-19937,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",144.66500000000002,72.33000000000001,40.67,209.1,28
CDM,RX-19964,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",1.96,0.98,0.12,227.85,28
CDM,RX-19967,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",10.41,5.125,2.03,12.85,26
CDM,RX-19981,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",65.57,32.79,1.06,308.18,28
CDM,RX-19985,DEXTROSE 5%-0.2% NACL IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-20106,"INJECTION, PYRIDOXINE HCL, 100 MG",144.54500000000002,72.27,23.07,292.95,28
CDM,RX-20159,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",290.01,145.0,11.07,394.41,32
CDM,RX-2043,CARVEDILOL 25 MG TABLET,15.129999999999999,7.5649999999999995,2.57,12.56,16
CDM,RX-2046,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",2516.0,1258.0,570.27,3421.76,32
CDM,RX-20547,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",383.325,191.66,5.92,621.96,28
CDM,RX-20629,SYNTHROID 125 MCG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-20675,"INJECTION, MEROPENEM, 100 MG",11.65,5.83,0.63,33.33,28
CDM,RX-20702,BUMETANIDE 0.5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-20713,"INJECTION, AZTREONAM, 100 MG",10.2,5.1,3.06,13.87,28
CDM,RX-20747,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,27.03,13.52,6.76,17.84,16
CDM,RX-20762,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",22.63,11.32,0.25,30.78,28
CDM,RX-20803,"INJECTION, MINOCYCLINE HYDROCHLORIDE, 1 MG",5.59,2.8,1.68,7.6,27
CDM,RX-20942,"INJECTION, MITOMYCIN, 5 MG",147.04500000000002,73.52000000000001,21.76,389.8,31
CDM,RX-20969,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",152.36,76.18,45.71,207.21,31
CDM,RX-21069,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",7.82,3.91,0.87,10.64,28
CDM,RX-21349,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,5.455,2.725,1.0,4.34,16
CDM,RX-21373,"INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS",10.0,5.0,3.0,13.6,28
CDM,RX-21663,LIDOCAINE 5 % TOPICAL PATCH,80.0,40.0,20.0,52.8,16
CDM,RX-21773,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",5.9,2.95,0.48,8.02,28
CDM,RX-21778,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",2.58,1.29,0.77,3.5,28
CDM,RX-21779,BETADINE 5% EYE SOLUTION,48.06,24.03,12.02,31.72,16
CDM,RX-21791,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",48.99,24.49,14.7,66.62,27
CDM,RX-21924,MIOSTAT VIAL,59.89,29.94,14.97,39.53,16
CDM,RX-21960,"CABERGOLINE, ORAL, 0.25 MG",6.76,3.38,2.03,30.24,28
CDM,RX-22054,AMPICILLIN 500 MG VIAL,29.67,14.83,7.42,19.58,16
CDM,RX-22062,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",166.17,83.08,44.98,225.99,32
CDM,RX-22082,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,68.0,34.0,10.0,60.29,16
CDM,RX-22104,"INJECTION, MESNA, 200 MG",22.46,11.23,2.81,115.55,28
CDM,RX-22143,"INJECTION, IRON SUCROSE, 1 MG",2.2199999999999998,1.11,0.4,4.75,28
CDM,RX-22167,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,12.36,6.18,3.09,8.16,16
CDM,RX-22180,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",6.07,3.04,1.82,16.19,27
CDM,RX-2251,CLONIDINE HCL 0.1 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-22531,"INJECTION, EPINEPHRINE (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",6.13,3.06,0.91,9.01,28
CDM,RX-22570,VALPROATE SOD 500 MG/5 ML VL,47.76,23.88,11.94,31.52,16
CDM,RX-2272,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",220.25,110.125,18.69,316.88,28
CDM,RX-22794,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",10.53,5.26,3.16,14.31,28
CDM,RX-22838,"INJECTION, INSULIN, PER 5 UNITS",9.22,4.61,0.87,12.54,28
CDM,RX-22912,FLECAINIDE 100 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-22942,PERPHENAZINE 4 MG TABLET,14.0,7.0,3.5,9.24,16
CDM,RX-22956,METOPROLOL TARTRATE 50 MG TABLET,8.85,4.425,1.92,6.6,16
CDM,RX-23001,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",221.66500000000002,110.83500000000001,39.22,316.88,28
CDM,RX-23035,NICOTINE 21 MG/24HR PATCH,13.65,6.82,3.41,9.01,16
CDM,RX-23196,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,15.56,28
CDM,RX-23228,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",2696.0,1348.0,674.0,1779.36,16
CDM,RX-23361,"INJECTION, AZITHROMYCIN, 500 MG",60.15,30.08,3.37,226.6,28
CDM,RX-2343,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",37.06,18.53,4.05,154.11,32
CDM,RX-23469,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",57.5,28.75,2.19,80.52,28
CDM,RX-2349,ACETAMINOPHEN 325 MG TABLET,9.41,4.705,1.95,8.16,16
CDM,RX-23533,"INJECTION, CLADRIBINE, PER 1 MG",126.74,63.37,12.24,250.36,31
CDM,RX-23564,"INJECTION, FENTANYL CITRATE, 0.1 MG",56.245000000000005,28.125,1.96,312.75,28
CDM,RX-23635,FLEET ENEMA,12.36,6.18,2.32,9.32,16
CDM,RX-2370,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",1.525,0.76,0.02,2.72,28
CDM,RX-2386,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",48.0,24.0,12.0,31.68,16
CDM,RX-23934,IBUPROFEN 200 MG TABLET,12.36,6.18,3.09,8.16,16
CDM,RX-24020,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,45.26,22.63,11.32,29.87,16
CDM,RX-24073,"INJECTION, AMPICILLIN SODIUM, 500 MG",17.299999999999997,8.649999999999999,0.97,25.72,28
CDM,RX-24154,BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL INJECTION SOLUTION,386.0,193.0,96.5,254.76,16
CDM,RX-24187,"INJECTION, MILRINONE LACTATE, 5 MG",34.94,17.47,2.23,47.51,28
CDM,RX-24199,"INJECTION, CALCITRIOL, 0.1 MCG",11.33,5.67,1.96,15.41,28
CDM,RX-24253,"INJECTION, AMPHOTERICIN B, 50 MG",150.25,75.13,45.08,204.34,28
CDM,RX-24303,ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,148.9,74.45,37.23,98.28,16
CDM,RX-24535,GABAPENTIN 300 MG CAPSULE,14.89,7.45,3.72,9.83,16
CDM,RX-2458,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,11.11,5.56,2.78,7.33,16
CDM,RX-24654,LIDOCAINE 2% VISCOUS 15 ML CUP,21.5,10.75,5.38,16.15,16
CDM,RX-24727,BACTERIOSTATIC SALINE VIAL,23.57,11.785,3.71,21.22,16
CDM,RX-24819,DEXTROSE 30 % IN WATER (D30W) INTRAVENOUS SOLUTION,103.0,51.5,25.75,67.98,16
CDM,RX-24908,"INJECTION, CYTARABINE, 100 MG",570.0,285.0,1.39,969.68,28
CDM,RX-24948,CYCLOMYDRIL EYE DROPS,119.0,59.5,29.75,78.54,16
CDM,RX-25089,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",16.74,8.37,0.05,54.4,28
CDM,RX-25100,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",17.55,8.775,3.42,28.86,28
CDM,RX-25133,ASPIRIN 81 MG CHEWABLE TABLET,10.19,5.09,0.77,6.4,16
CDM,RX-25309,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",92.45,46.23,22.8,125.74,28
CDM,RX-25506,UNCLASSIFIED DRUGS,125.36,62.68,37.61,170.5,26
CDM,RX-25535,STERILE WATER FOR INJECTION,155.0,77.5,38.75,102.3,16
CDM,RX-25579,VISCOAT SYRINGE,160.27,80.13,40.07,105.78,16
CDM,RX-25714,BUMETANIDE 1 MG TABLET,16.43,8.21,4.11,10.84,16
CDM,RX-25790,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,13.065000000000001,6.535,3.75,9.9,16
CDM,RX-25922,FOLIC ACID 1 MG TABLET,11.76,5.88,2.94,7.76,16
CDM,RX-25971,"INJECTION, ENOXAPARIN SODIUM, 10 MG",221.0,110.5,0.87,307.35,28
CDM,RX-25986,"INJECTION, CIDOFOVIR, 375 MG",2832.4,1416.2,400.01,3852.06,31
CDM,RX-26069,MONTELUKAST SOD 10 MG TABLET,16.18,8.09,3.09,13.2,16
CDM,RX-26112,HYDROXYZINE HCL 25 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-26128,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",30.0,15.0,7.5,19.8,16
CDM,RX-26190,"CYCLOSPORINE, ORAL, 100 MG",19.78,9.89,2.99,26.9,28
CDM,RX-26203,ALLOPURINOL 300 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-26246,"INJECTION, HALOPERIDOL, UP TO 5 MG",224.02,112.01,1.2,312.53,28
CDM,RX-26442,"INJECTION, AMPICILLIN SODIUM, 500 MG",21.375,10.684999999999999,0.97,39.98,28
CDM,RX-26445,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",97.03999999999999,48.519999999999996,0.57,316.88,28
CDM,RX-26663,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",17.17,8.58,5.15,23.35,28
CDM,RX-26707,CLONIDINE 0.3 MG/DAY PATCH,74.85,37.43,18.71,49.4,16
CDM,RX-26781,REGONOL 10 MG/2 ML AMPUL,158.54,79.27,40.73,134.11,16
CDM,RX-26917,HYDROCHLOROTHIAZIDE 25 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-26942,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,91.16,45.58,22.79,60.17,16
CDM,RX-26982,DIGOXIN 125 MCG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-27067,ZOLPIDEM TARTRATE 5 MG TABLET,28.0,14.0,7.0,18.48,16
CDM,RX-27155,"INJECTION, BUMETANIDE, 0.5 MG",8.36,4.18,0.58,32.8,28
CDM,RX-27159,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.3399999999999999,0.6699999999999999,0.27,1.71,28
CDM,RX-27165,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",7.84,3.92,2.33,22.56,28
CDM,RX-27182,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",866.72,433.36,95.72,1195.91,31
CDM,RX-27313,GABAPENTIN 100 MG CAPSULE,20.0,10.0,5.0,13.2,16
CDM,RX-27385,UNCLASSIFIED DRUGS,32.855,16.425,5.95,246.98,26
CDM,RX-27420,"METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",10.0,5.0,2.5,6.6,16
CDM,RX-27519,HYDROCORTISONE 10 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-27593,MAG-AL PLUS SUSPENS 30 ML CUP,20.0,10.0,5.0,13.2,16
CDM,RX-27806,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.88,0.94,0.25,2.56,28
CDM,RX-27839,IRBESARTAN 150 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-27853,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",11.56,5.78,0.13,15.72,28
CDM,RX-27891,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.36,3.06,0.18,138.11,28
CDM,RX-27964,LORAZEPAM 1 MG TABLET,18.634999999999998,9.32,3.75,14.7,16
CDM,RX-28034,"INJECTION, AZTREONAM, 100 MG",13.8,6.9,3.68,18.77,28
CDM,RX-28166,"INJECTION, INSULIN, PER 5 UNITS",7.79,3.9,0.39,26.38,28
CDM,RX-2818,DOXYCYCLINE HYCLATE 100 MG CAPSULE,20.0,10.0,5.0,13.2,16
CDM,RX-28230,HYDROXYCHLOROQUINE 200 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-28269,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",218.91,109.46,0.71,314.55,28
CDM,RX-28295,PHENYLEPHRINE 2.5 % EYE DROPS,221.535,110.77,23.86,229.44,16
CDM,RX-28362,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",217.0,108.5,0.05,316.88,28
CDM,RX-28366,"INJECTION, MANNITOL, 250 MG",157.95,78.97,64.29,214.81,20
CDM,RX-28394,IBUPROFEN 600 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-28410,"INJECTION, CEFTAZIDIME, PER 500 MG",27.174999999999997,13.585,2.43,62.82,28
CDM,RX-2847,"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",20.0,10.0,5.0,13.2,16
CDM,RX-28547,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",13.415,6.705,1.22,24.29,28
CDM,RX-28574,"INJECTION, PROPOFOL, 10 MG",1.49,0.75,0.15,25.86,28
CDM,RX-2858,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",2.17,1.09,0.65,2.96,28
CDM,RX-28623,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",34.3,17.15,10.29,46.65,28
CDM,RX-28705,FENTANYL 25 MCG/HR PATCH,80.475,40.24,9.43,81.35,16
CDM,RX-28739,"INJECTION, PACLITAXEL, 1 MG",11.18,5.59,0.17,15.85,28
CDM,RX-28866,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",29.51,14.76,3.65,43.18,28
CDM,RX-2891,"INJECTION, IMIGLUCERASE, 10 UNITS",147.01,73.5,44.1,9401.8,31
CDM,RX-28926,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.39,1.69,0.68,4.61,28
CDM,RX-28965,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",73.87,36.93,3.58,312.53,28
CDM,RX-28973,LEVOFLOXACIN 750 MG TABLET,11.07,5.54,2.77,7.31,16
CDM,RX-29037,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,44.55,22.275,6.67,35.33,16
CDM,RX-29080,SODIUM PHOSPHATE 45 MMOL/15 ML,117.25,58.63,24.88,84.46,16
CDM,RX-29134,NEOMYCIN 500 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-29180,VENTOLIN HFA 90 MCG INHALER,114.495,57.25,24.33,81.38,16
CDM,RX-29293,DILTIAZEM 30 MG TABLET,16.18,8.09,3.71,12.56,16
CDM,RX-29326,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.24,0.62,0.3,1.68,28
CDM,RX-29371,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",76.2,38.1,0.54,300.47,27
CDM,RX-29372,"DEXAMETHASONE, ORAL, 0.25 MG",2.97,1.48,0.02,4.04,28
CDM,RX-2939,ATORVASTATIN 20 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-29397,"DEXAMETHASONE, ORAL, 0.25 MG",1.04,0.52,0.02,1.41,28
CDM,RX-29500,INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,174.45,87.22,43.61,115.14,16
CDM,RX-29510,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1.69,0.85,0.51,604.48,32
CDM,RX-29588,"INJECTION, IBUTILIDE FUMARATE, 1 MG",637.0,318.5,145.38,866.32,31
CDM,RX-29743,CELECOXIB 100 MG CAPSULE,49.0,24.5,12.25,32.34,16
CDM,RX-29807,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-29912,OXYBUTYNIN 5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-2996,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",576.0799999999999,288.03999999999996,95.72,834.33,31
CDM,RX-29980,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",2.64,1.32,0.58,3.59,28
CDM,RX-29987,MORPHINE SULFATE IR 15 MG TAB,12.36,6.18,3.09,8.16,16
CDM,RX-300194,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",38.99,19.5,0.3,53.03,28
CDM,RX-300392,CHLOROTHIAZIDE 25 MG/ML INJECTION,168.76,84.38,42.19,111.38,16
CDM,RX-300402,METHOTREXATE 50 MG/2 ML VIAL,473.535,236.77,7.89,403.56,16
CDM,RX-300430,VANCOMYCIN IN NS ENEMA,42.0,21.0,10.5,27.72,16
CDM,RX-300803,"EPINEPHRINE 1:20,000 MUCOSAL SOLUTION",8.1,4.05,2.03,5.35,16
CDM,RX-300837,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",217.0,108.5,0.76,314.55,28
CDM,RX-300946,NUTRILIPID 20% IV FAT EMULSION,98.0,49.0,24.5,64.68,16
CDM,RX-301042,"INJECTION, DEGARELIX, 1 MG",30.35,15.18,7.34,389.8,31
CDM,RX-301111,SODIUM CHLORIDE 0.9% VIAL,56.0,28.0,14.0,36.96,16
CDM,RX-301142,VANCOMYCIN (PF)INTRAVENTRICULAR SYRINGE,39.5,19.75,9.88,26.07,16
CDM,RX-30115,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5013.33,2506.66,1504.0,6818.13,31
CDM,RX-301242,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",64.88,32.44,13.5,1677.59,31
CDM,RX-301598,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",56.41,28.21,2.19,76.72,28
CDM,RX-301963,REMIFENTANIL 2 MG VIAL,213.67,106.83,53.42,141.02,16
CDM,RX-301983,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.2,3.1,0.3,8.43,28
CDM,RX-30249,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",101.11500000000001,50.555,15.42,736.42,31
CDM,RX-30301,PROPARACAINE 0.5 % EYE DROPS,118.755,59.375,26.85,85.88,16
CDM,RX-303027,TPN - NEONATAL STARTER INFUSION,327.0,163.5,81.75,215.82,16
CDM,RX-303100,TPN ADULT CENTRAL LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303102,TPN ADULT PERIPHERAL LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303103,TPN PEDS CENTRAL LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303105,TPN NEO PERIPHERAL LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303107,TPN NEO CENTRAL LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303125,TPN NEO INTERMEDIATE LINE INFUSION (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-303128,TPN ADULT CENTRAL LINE INFUSION - CYCLIC (RUMC),1725.0,862.5,431.25,1138.5,16
CDM,RX-30317,FENTANYL 75 MCG/HR PATCH,75.0,37.5,18.75,49.5,16
CDM,RX-30444,"METHYLPREDNISOLONE ORAL, PER 4 MG",3.35,1.67,0.23,4.55,28
CDM,RX-3050,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",47.72,23.86,1.78,238.5,28
CDM,RX-30509,ATROPINE 1 % EYE DROPS,125.28,62.64,31.32,82.69,16
CDM,RX-30527,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",8.75,4.38,0.02,23.42,28
CDM,RX-30670,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.25,1.625,0.18,4.24,28
CDM,RX-30694,"TEMOZOLOMIDE, ORAL, 5 MG",21.73,10.87,0.89,29.56,28
CDM,RX-30763,"INJECTION, VINORELBINE TARTRATE, 10 MG",66.66999999999999,33.334999999999994,8.98,90.77,28
CDM,RX-31006,FLUOXETINE HCL 20 MG CAPSULE,10.0,5.0,2.5,6.6,16
CDM,RX-31012,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",521.0,260.5,130.25,343.86,16
CDM,RX-31061,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",145.65,72.83,12.77,310.95,31
CDM,RX-31107,SORBITOL 70 % SOLUTION,19.93,9.96,4.98,13.15,16
CDM,RX-31113,SERTRALINE 50 MG TABLET,12.31,6.15,3.08,8.12,16
CDM,RX-31177,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",113.96,56.98,0.3,295.12,28
CDM,RX-31196,UNCLASSIFIED BIOLOGICS,51.2,25.6,15.36,69.63,26
CDM,RX-31222,"INJECTION, RITUXIMAB, 10 MG",272.405,136.2,81.76,4737.06,31
CDM,RX-31267,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,1289.315,644.66,84.4,1479.07,16
CDM,RX-31269,DEXTROSE 5%-0.45% NACL IV SOLN,102.33,51.17,6.25,82.83,32
CDM,RX-31278,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",476.11,238.06,121.68,747.33,31
CDM,RX-3131,ROPINIROLE 1 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-31358,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",9.21,4.61,0.33,12.53,28
CDM,RX-3149,NICOTINE 14 MG/24HR PATCH,22.965,11.48,3.98,19.8,16
CDM,RX-31516,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,62.05,31.025,1.23,75.36,16
CDM,RX-31567,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",220.2,110.1,21.45,295.12,28
CDM,RX-3160,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,99.14500000000001,49.57,22.74,74.73,16
CDM,RX-31631,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",71.01,35.5,21.3,96.57,28
CDM,RX-31657,DICYCLOMINE 10 MG CAPSULE,10.0,5.0,2.5,6.6,16
CDM,RX-3166,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",576.5,288.25,184.48,4986.37,31
CDM,RX-31676,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",6.115,3.06,0.97,9.26,27
CDM,RX-31677,ATENOLOL 50 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-31758,CALCITRIOL 0.25 MCG CAPSULE,20.0,10.0,5.0,13.2,16
CDM,RX-31761,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",14.24,7.12,4.27,19.36,28
CDM,RX-3189,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",12.07,6.03,0.33,27.2,28
CDM,RX-319,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",135.915,67.955,0.54,316.88,27
CDM,RX-31913,FINASTERIDE 5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-31917,"LEUPROLIDE ACETATE, PER 1 MG",333.245,166.625,43.27,710.29,28
CDM,RX-32066,LEVOPHED 4 MG/4 ML VIAL,34.75,17.38,8.69,22.94,16
CDM,RX-3212,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",575.66,287.83,170.85,7661.86,31
CDM,RX-32228,LORATADINE 10 MG TABLET,20.0,10.0,4.53,37.8,16
CDM,RX-32238,PLASMA-LYTE A PH 7.4 SOLN.,77.0,38.5,15.45,67.65,16
CDM,RX-32313,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",11.13,5.57,0.66,15.14,28
CDM,RX-32417,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",83.86,41.93,22.28,114.05,28
CDM,RX-32879,DIAZEPAM 5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-32886,METOCLOPRAMIDE 10 MG TABLET,12.36,6.18,3.09,8.16,16
CDM,RX-3289,KETOCONAZOLE 2 % SHAMPOO,61.0,30.5,15.25,40.26,16
CDM,RX-32898,SODIUM CHLORIDE 3% IV SOLN,100.2,50.1,25.05,66.13,16
CDM,RX-33001,SYNTHROID 112 MCG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-33010,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,29.9,14.95,7.48,19.74,16
CDM,RX-33166,"INJECTION, ESTROGEN CONJUGATED, PER 25 MG",717.57,358.79,215.27,975.9,31
CDM,RX-33180,"INJECTION, ARSENIC TRIOXIDE, 1 MG",146.47,73.23,4.68,199.19,32
CDM,RX-33230,SODIUM CHLORIDE 400 MEQ/100 ML,57.51,28.76,14.38,37.96,16
CDM,RX-33264,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",7.57,3.78,0.4,246.98,28
CDM,RX-33281,AMOX-CLAV 500-125 MG TABLET,23.33,11.665,3.5,21.98,16
CDM,RX-33302,ANTI-DANDRUFF 1% SHAMPOO,29.0,14.5,7.25,19.14,16
CDM,RX-33329,NICODERM CQ 7 MG/24HR PATCH,14.93,7.47,3.73,9.86,16
CDM,RX-33389,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",55.27,27.64,16.58,75.17,28
CDM,RX-33393,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",12.97,6.48,0.33,17.63,28
CDM,RX-33400,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,35.6,17.8,8.9,23.5,16
CDM,RX-33421,"INJECTION, METOPROLOL TARTRATE, 1 MG",14.829999999999998,7.414999999999999,0.2,54.4,28
CDM,RX-33439,"INJECTION, CARBOPROST TROMETHAMINE, 0.1 MG",284.58,142.29,115.83,387.03,20
CDM,RX-33467,"INJECTION, LEVOCARNITINE, PER 1 GM",95.94,47.97,28.78,130.48,28
CDM,RX-33468,KETAMINE 500 MG/5 ML VIAL,224.6,112.3,13.24,331.58,16
CDM,RX-33547,CYCLOGYL 0.5% EYE DROPS,247.0,123.5,61.75,163.02,16
CDM,RX-33623,OXYCODONE 5 MG TABLET,10.07,5.03,2.52,6.65,16
CDM,RX-33706,FLUMAZENIL 0.5 MG/5 ML VIAL,58.85,29.42,14.71,38.84,16
CDM,RX-33844,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",225.39499999999998,112.695,67.77,2382.19,31
CDM,RX-33931,"INJECTION, ERTAPENEM SODIUM, 500 MG",133.57,66.79,15.11,232.41,28
CDM,RX-3440,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",5.27,2.63,0.3,13.26,28
CDM,RX-34545,DAKIN'S 0.25% SOLUTION,52.925,26.465,11.34,39.91,16
CDM,RX-34546,DAKIN'S 0.5% SOLUTION,61.0,30.5,15.25,40.26,16
CDM,RX-34603,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",58.44,29.22,17.53,79.48,28
CDM,RX-350010,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",222.33,111.17,6.06,304.55,28
CDM,RX-350022,HTK PERFUSION SOLUTION,1386.07,693.03,346.52,914.81,16
CDM,RX-350027,"INJECTION, FENTANYL CITRATE, 0.1 MG",7.2,3.6,1.96,9.79,28
CDM,RX-350029,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",33.89,16.95,5.02,46.09,28
CDM,RX-350048,AMIKACIN 400 MCG/0.1 ML INTRAVITREAL SOLUTION,75.0,37.5,18.75,49.5,16
CDM,RX-350138,GLUCOSE TOLERANCE TEST SOLUTION 100 G/296 ML,28.0,14.0,7.0,18.48,16
CDM,RX-350214,ARREST CART,798.8,399.4,199.7,527.21,16
CDM,RX-350215,OPIUM DEODORIZED TINCTURE 0.6 ML SYRINGE,73.0,36.5,18.25,48.18,16
CDM,RX-350233,NUTRILIPID 20% IV FAT EMULSION,98.98,49.49,24.75,65.33,16
CDM,RX-350235,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",1.1099999999999999,0.55,0.03,1.58,28
CDM,RX-350270,"INJECTION, INSULIN, PER 5 UNITS",10.0,5.0,0.87,13.6,28
CDM,RX-350272,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",102.71,51.35,2.13,139.68,28
CDM,RX-350291,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",103.0,51.5,2.13,140.08,28
CDM,RX-350292,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",102.52,51.26,1.09,139.43,28
CDM,RX-350293,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",103.0,51.5,2.13,140.08,28
CDM,RX-350294,"INJECTION, EPTIFIBATIDE, 5 MG",26.62,13.31,5.81,47.67,31
CDM,RX-350306,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE (HYPOGLYCEMIA PROTOCOL),100.675,50.34,24.59,64.93,16
CDM,RX-350308,DEXTROSE 10%-WATER IV SOLUTION,102.31,51.15,25.58,67.52,16
CDM,RX-350316,CRRT (NXSTAGE) 5 L SOLUTION,103.0,51.5,25.75,67.98,16
CDM,RX-350323,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",68.92500000000001,34.46,8.15,94.42,28
CDM,RX-350334,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.47,0.735,0.25,2.54,28
CDM,RX-350348,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
CDM,RX-350351,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
CDM,RX-350352,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),21.12,10.56,2.16,28.72,28
CDM,RX-350353,DEXTROSE 5% IN WATER IV (CHEMO),62.315,31.16,6.92,53.15,16
CDM,RX-350354,DEXTROSE 5%-0.45% NACL IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-350357,"RINGERS LACTATE INFUSION, UP TO 1000 CC",103.0,51.5,3.93,140.08,28
CDM,RX-350358,SODIUM CHLORIDE 0.45% SOLN,355.35,177.68,88.84,234.53,16
CDM,RX-350359,UNCLASSIFIED DRUGS,76.4,38.2,12.1,139.77,26
CDM,RX-350366,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",7.890000000000001,3.9450000000000003,0.36,11.88,28
CDM,RX-350367,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",325.0,162.5,69.9,874.99,31
CDM,RX-350369,5% DEXTROSE/WATER (500 ML = 1 UNIT),66.45,33.225,2.89,130.52,28
CDM,RX-350370,UNCLASSIFIED DRUGS,24.26,12.13,7.24,170.68,26
CDM,RX-350403,BACTERIOSTATIC SALINE VIAL,40.79,20.395,8.58,34.96,16
CDM,RX-350414,SODIUM CHLORIDE 3% IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-350475,AMPHOTERICIN B 50 MCG/ML INTRA-OPHTHALMIC SOLUTION,99.0,49.5,24.75,65.34,16
CDM,RX-350483,ESMOLOL 100 MG/10 ML IV SYRINGE,79.0,39.5,19.75,52.14,16
CDM,RX-350487,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",111.13499999999999,55.57,1.09,170.68,28
CDM,RX-350496,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.03,3.02,0.3,8.21,28
CDM,RX-350502,ACETAMINOPHEN 325 MG/10.15 ML,12.86,6.43,3.21,8.49,16
CDM,RX-350510,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",103.0,51.5,3.28,140.08,28
CDM,RX-350522,METHOHEXITAL 100 MG/10ML-WATER,149.82,74.91,37.46,98.88,16
CDM,RX-350574,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",132.08499999999998,66.03999999999999,26.68,428.4,32
CDM,RX-350577,LIPIODOL ULTRA-FLUIDE 48% INJECTION,3569.35,1784.67,892.34,2355.77,16
CDM,RX-350641,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",23.88,11.94,0.05,84.0,17
CDM,RX-350644,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",101.54,50.775,1.09,169.43,28
CDM,RX-350656,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",42.75,21.38,1.44,58.14,28
CDM,RX-350670,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",5.16,2.58,0.3,7.02,28
CDM,RX-350677,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",2.74,1.37,0.36,3.72,28
CDM,RX-350745,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",2.51,1.25,0.25,3.41,28
CDM,RX-350748,"INJECTION, OXYTOCIN, UP TO 10 UNITS",41.59,20.79,4.44,56.56,28
CDM,RX-350749,"INJECTION, OXYTOCIN, UP TO 10 UNITS",40.16,20.08,4.44,54.62,28
CDM,RX-350750,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",262.34,131.17,57.87,467.62,31
CDM,RX-350751,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",15.22,7.61,0.2,741.2,28
CDM,RX-350752,"INJECTION, VORICONAZOLE, 10 MG",237.0,118.5,1.24,322.32,28
CDM,RX-350780,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",3.87,1.93,1.16,4737.06,31
CDM,RX-350782,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",3.64,1.82,1.09,5897.78,31
CDM,RX-350784,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",5.9,2.95,1.77,5897.78,31
CDM,RX-350786,"TACROLIMUS, PARENTERAL, 5 MG",488.0,244.0,145.38,663.68,31
CDM,RX-350788,"INJECTION, VORICONAZOLE, 10 MG",3.9,1.95,1.17,5.3,28
CDM,RX-350793,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE (GLUCOSTABILIZER),101.05,50.53,25.26,66.69,16
CDM,RX-350795,"INJECTION, FENTANYL CITRATE, 0.1 MG",8.12,4.06,1.96,11.04,28
CDM,RX-350796,"INJECTION, FENTANYL CITRATE, 0.1 MG",7.68,3.84,1.96,10.44,28
CDM,RX-350800,DIANEAL PD-2 WITH 1.5% DEXT,103.0,51.5,25.75,67.98,16
CDM,RX-350801,DIANEAL PD-2 WITH 2.5% DEXT,103.0,51.5,25.75,67.98,16
CDM,RX-350802,DIANEAL PD-2 WITH 4.25% DEXT,103.0,51.5,25.75,67.98,16
CDM,RX-350803,DIANEAL WITH 1.5% DEXTROSE,103.0,51.5,25.75,67.98,16
CDM,RX-350804,DIANEAL WITH 2.5% DEXTROSE,103.0,51.5,25.75,67.98,16
CDM,RX-350805,DIANEAL WITH 4.25% DEXTROSE,103.0,51.5,25.75,67.98,16
CDM,RX-350806,HISTAMINE DICHLORIDE 6 MG/ML TOPICAL SOLUTION,2541.0,1270.5,635.25,1677.06,16
CDM,RX-350812,SODIUM CHLORIDE 0.9% VIAL,55.0,27.5,13.75,36.3,16
CDM,RX-350820,"INJECTION, BORTEZOMIB, 0.1 MG",662.95,331.475,4.42,962.55,32
CDM,RX-350823,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.29,0.65,0.3,1.75,28
CDM,RX-350827,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH (PERIOPERATIVE USE),27.0,13.5,6.75,17.82,16
CDM,RX-350851,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",127.0,63.5,11.07,172.72,32
CDM,RX-350857,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.12,3.06,0.3,8.32,28
CDM,RX-350888,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",1.24,0.62,0.12,1.69,28
CDM,RX-350891,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",73.405,36.705,3.28,140.08,28
CDM,RX-350892,PSYLLIUM ORAL PACKET (BUNDLED),20.0,10.0,5.0,13.2,16
CDM,RX-350894,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",6.16,3.08,1.85,2382.19,31
CDM,RX-350898,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",503.83,251.91,121.68,685.2,31
CDM,RX-350918,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",6.31,3.16,1.01,128.98,31
CDM,RX-350919,"ANTITHROMBIN III (HUMAN), PER I.U.",10.59,5.3,3.18,5897.78,31
CDM,RX-350921,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",30.015,15.01,0.23,227.67,28
CDM,RX-350922,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",222.865,111.435,0.23,311.08,28
CDM,RX-350924,"INJECTION, INSULIN, PER 5 UNITS",65.45,32.73,0.87,89.01,28
CDM,RX-350936,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",3.23,1.62,0.97,4.4,28
CDM,RX-350939,ROCURONIUM 50 MG/5 ML VIAL,12.18,6.09,3.05,8.04,16
CDM,RX-350943,"INJECTION, PROPOFOL, 10 MG",8.79,4.395,0.15,20.4,28
CDM,RX-350944,LIDOCAINE HCL 4% SOLUTION,156.65,78.325,34.07,125.44,16
CDM,RX-350954,NIFEDIPINE EXTENDED RELEASE 60 MG TAB (BUNDLED ERX),20.0,10.0,5.0,13.2,16
CDM,RX-351045,CEFTAZIDIME 2 MG/0.1 ML INTRAVITREAL SOLUTION,148.0,74.0,37.0,97.68,16
CDM,RX-351047,VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL INJECTION,127.5,63.75,31.88,84.15,16
CDM,RX-351054,SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE,337.0,168.5,84.25,222.42,16
CDM,RX-351056,"INJECTION, METHOTREXATE SODIUM, 50 MG",122.77,61.385,4.26,280.5,28
CDM,RX-351060,"INJECTION, AZACITIDINE, 1 MG",5.2,2.6,0.76,1207.95,32
CDM,RX-351066,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5214.12,2607.06,1564.24,7091.2,31
CDM,RX-351079,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3.26,1.63,0.98,4737.06,31
CDM,RX-351083,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",12.54,6.27,0.23,17.05,28
CDM,RX-351089,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IV (FOR ADS),178.33,89.17,44.58,117.7,16
CDM,RX-351093,"INJECTION, ERTAPENEM SODIUM, 500 MG",92.79,46.4,15.11,201.38,28
CDM,RX-351104,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.36,0.68,0.08,1.84,28
CDM,RX-351122,SORE THROAT LOZENGES,115.68,57.845,6.78,131.1,16
CDM,RX-351135,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.87,0.87,10.54,28
CDM,RX-351137,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.87,0.87,10.54,28
CDM,RX-351138,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.87,0.87,10.54,28
CDM,RX-351139,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.88,0.87,10.54,28
CDM,RX-351155,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR (11 ML),24.96,12.48,7.07,16.47,16
CDM,RX-351164,NITROGLYCERIN 400 MCG/10 ML IV SYRINGE (OR PACK),163.8,81.9,40.95,108.11,16
CDM,RX-351169,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",3.07,1.54,0.12,4.18,28
CDM,RX-351174,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",332.69,166.35,0.68,872.44,28
CDM,RX-351180,"INJECTION, CEFOXITIN SODIUM, 1 GM",65.0,32.5,7.82,88.4,28
CDM,RX-351181,"INJECTION, CEFOXITIN SODIUM, 1 GM",58.0,29.0,7.82,78.88,28
CDM,RX-351203,NUTRILIPID 20% IV FAT EMULSION,99.09,49.54,24.77,65.4,16
CDM,RX-351205,SODIUM POLYSTYRENE SULFONATE 15 G/60 ML ORAL SUSP (BUNDLED ERX),73.85,36.93,18.46,48.74,16
CDM,RX-351211,AZITHROMYCIN 500 MG IV PIGGYBACK (FOR ADS),155.0,77.5,38.75,102.3,16
CDM,RX-351224,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.47,0.74,0.3,2.0,28
CDM,RX-351225,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.43,3.21,0.3,8.74,28
CDM,RX-351229,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",37.31,18.65,0.68,51.0,28
CDM,RX-351252,THIAMINE 100 MG TABLET (BUNDLED ERX),20.0,10.0,5.0,13.2,16
CDM,RX-351259,"RINGERS LACTATE INFUSION, UP TO 1000 CC",72.775,36.39,3.93,137.16,28
CDM,RX-351260,PLASMA-LYTE A PH 7.4 SOLN.,96.38,48.19,24.1,63.61,16
CDM,RX-351269,EPHEDRINE (PF) 5 MG/ML IV - BUNDLED,93.96000000000001,46.985,20.1,70.97,16
CDM,RX-351270,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",103.0,51.5,1.09,140.08,28
CDM,RX-351271,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",60.0,30.0,3.07,97.73,28
CDM,RX-351278,METOPROLOL 5 MG/5 ML IV (CARDIAC MRI STRESS LAB),41.144999999999996,20.575,9.41,24.83,16
CDM,RX-351280,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV (FOR L+D ORDER SET ONLY)",61.77,30.88,15.44,40.77,16
CDM,RX-351281,AMINOPHYLLINE 250 MG/10 ML IV - STRESS LAB + MRI ONLY,15.3,7.65,3.83,10.1,16
CDM,RX-351281,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",56.21,28.11,16.86,76.45,28
CDM,RX-351282,EPOPROSTENOL 30 MCG/ML INHALATION SOLUTION,265.0,132.5,66.25,174.9,16
CDM,RX-351285,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",98.86,49.43,3.28,134.45,28
CDM,RX-351295,MOXIFLOXACIN (PF) 5 MG/ML OPHTHALMIC INJECTION,142.96,71.48,35.74,94.35,16
CDM,RX-351297,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",119.045,59.525,5.02,308.38,28
CDM,RX-351306,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",3.58,1.79,0.05,4.87,28
CDM,RX-351315,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",2.87,1.43,0.35,3.9,28
CDM,RX-351318,"INJECTION, HYDROMORPHONE, 0.1 MG",3.75,1.87,0.09,5.09,28
CDM,RX-351329,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",17.85,8.92,0.33,24.27,28
CDM,RX-351342,"INJECTION, HYDROMORPHONE, 0.1 MG",222.33,111.17,0.09,307.69,28
CDM,RX-351345,"INJECTION, LINEZOLID (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J2020, 200 MG",27.02,13.51,8.11,36.74,28
CDM,RX-351350,"INJECTION FLUCONAZOLE, 200 MG",154.29000000000002,77.14500000000001,7.39,209.55,28
CDM,RX-351352,"INJECTION, BEVACIZUMAB, 10 MG",423.0,211.5,121.49,2382.19,31
CDM,RX-351358,KETAMINE 50 MG/5 ML (10 MG/ML) IN NS IV SYRINGE,101.58,50.79,24.0,76.97,16
CDM,RX-351359,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",50.98,25.49,3.15,74.25,28
CDM,RX-351360,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",73.95,36.975,3.15,105.06,28
CDM,RX-351364,FENTANYL 2 MCG/ML-BUPIVACAINE 0.0625% INTRATHECAL INFUSION (L+D),155.0,77.5,38.75,102.3,16
CDM,RX-351372,FENTANYL-BUPIVACAINE IN NS (PF) 2 MCG/ML-0.0625 % INFUSION (PIEB),155.0,77.5,38.75,102.3,16
CDM,RX-351383,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",358.495,179.245,78.19,1677.59,31
CDM,RX-351385,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",155.0,77.5,3.58,210.8,28
CDM,RX-351386,DEXMEDETOMIDINE 400 MCG/100 ML NS (4 MCG/ML) IV INFUSION,169.57,84.785,46.12,122.36,16
CDM,RX-351391,DILTIAZEM CD 120 MG 24 HR CAP (BUNDLED),13.33,6.67,3.33,8.8,16
CDM,RX-351392,DILTIAZEM CD 180 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
CDM,RX-351393,DILTIAZEM CD 240 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
CDM,RX-351394,DILTIAZEM CD 300 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
CDM,RX-351397,MULTIVITAMINS WITH MINERALS TAB (BUNDLED),8.0,4.0,2.0,5.28,16
CDM,RX-351428,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",114.42999999999999,57.21,0.36,309.63,28
CDM,RX-351431,"INJECTION, HYDROMORPHONE, 0.1 MG",7.07,3.53,0.09,234.92,28
CDM,RX-351432,5% DEXTROSE/WATER (500 ML = 1 UNIT),100.67,50.34,2.89,136.91,28
CDM,RX-351500,"INJECTION, VORICONAZOLE, 10 MG",3.65,1.83,1.1,4.97,28
CDM,RX-351502,EPINEPHRINE 8 MG/250 ML (32 MCG/ML) IV INFUSION FOR ADS,174.1,87.05,43.52,114.9,16
CDM,RX-351503,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",3.09,1.54,0.36,4.2,28
CDM,RX-351504,CARBOPLATIN 10 MG/ML IV FOR DESENSITIZATION,45.17,22.585,4.24,44.76,16
CDM,RX-351510,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",133.865,66.93,4.95,298.84,32
CDM,RX-351511,UNCLASSIFIED DRUGS,179.26999999999998,89.63499999999999,41.92,347.53,26
CDM,RX-351512,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",566.0,283.0,121.68,769.76,31
CDM,RX-351602,SODIUM CHLORIDE 0.45% SOLN,406.43,203.215,25.54,446.32,16
CDM,RX-351603,5% DEXTROSE/WATER (500 ML = 1 UNIT),75.88,37.94,2.89,103.19,28
CDM,RX-351605,DEXTROSE 5%-0.2% NACL IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-351660,UNCLASSIFIED DRUGS,36.97,18.49,9.71,170.68,26
CDM,RX-351690,"INJECTION, HYDROMORPHONE, 0.1 MG",8.435,4.220000000000001,0.09,306.0,28
CDM,RX-351728,EPHEDRINE SULFATE 50 MG/ML VL,171.70499999999998,85.85499999999999,28.34,140.32,16
CDM,RX-351743,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",219.5,109.75,65.85,1677.59,31
CDM,RX-351744,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",209.0,104.5,62.7,1677.59,31
CDM,RX-351745,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",202.91,101.46,60.87,1677.59,31
CDM,RX-351746,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",201.1,100.55,60.33,1677.59,31
CDM,RX-351756,VIAFLEX EMPTY STERILE BAG 150 ML,42.0,21.0,10.5,27.72,16
CDM,RX-351761,"INJECTION, BACLOFEN, 10 MG",574.64,287.32,172.39,781.51,31
CDM,RX-351762,"INJECTION, BACLOFEN, 10 MG",481.63,240.81,144.49,655.01,31
CDM,RX-351798,"INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U.",3.15,1.57,0.94,2382.19,31
CDM,RX-351811,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",180.75,90.38,54.23,245.82,28
CDM,RX-351814,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",286.89,143.445,65.1,485.22,31
CDM,RX-351869,"INJECTION, ARGATROBAN (AUROMEDICS), NOT THERAPEUTICALLY EQUIVALENT TO J0883, 1 MG (FOR NON-ESRD USE)",2.02,1.01,0.61,128.98,32
CDM,RX-351909,TRANEXAMIC ACID (CYKLOKAPRON) 100 MG/ML INHALATION SOLUTION,60.97,30.48,15.24,40.24,16
CDM,RX-351933,"INJECTION, INSULIN, PER 5 UNITS",25.0,12.5,0.87,34.0,28
CDM,RX-351936,FAT EMULSION (SMOFLIPID) 20% INFUSION,154.87,77.43,38.72,102.21,16
CDM,RX-351976,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",154.99,77.5,46.5,210.79,26
CDM,RX-351994,DEXTROSE 10%-WATER IV SOLUTION,95.9,47.95,23.98,63.3,16
CDM,RX-352000,"INJECTION, EPINEPHRINE (BPI), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",127.69,63.845,1.83,316.88,28
CDM,RX-352001,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",68.595,34.3,5.24,292.95,28
CDM,RX-352007,MOMETASONE 220 MCG BREATH ACTIVATED POWDER AEROSOL (BUNDLED),125.66,62.83,31.41,82.93,16
CDM,RX-352010,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",490.05,245.025,69.9,784.45,31
CDM,RX-352113,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",14.75,7.38,0.68,20.06,28
CDM,RX-352116,"COCAINE HYDROCHLORIDE NASAL SOLUTION (GOPRELTO), 1 MG",3.28,1.64,0.98,4.45,26
CDM,RX-352207,"MIFEPRISTONE, ORAL, 200 MG",148.0,74.0,36.55,201.28,30
CDM,RX-352225,FERROUS SULF EC 325 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-352229,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",4.09,2.05,0.68,5.57,28
CDM,RX-352259,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",6.61,3.3,1.98,2382.19,31
CDM,RX-352288,"INJECTION, FENTANYL CITRATE, 0.1 MG",4.03,2.01,1.21,5.48,28
CDM,RX-352304,PHENYLEPHRINE 100 MCG/1 ML SYRINGE,29.8,14.9,7.45,19.67,16
CDM,RX-352307,"PRECEDEX 1,000 MCG/250 ML BTL",263.03,131.52,65.76,173.6,16
CDM,RX-352321,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",38.75,19.38,2.1,52.7,28
CDM,RX-352326,"INJECTION, CEFAZOLIN SODIUM, 500 MG",28.0,14.0,1.37,38.08,28
CDM,RX-352369,5% DEXTROSE/WATER (500 ML = 1 UNIT),21.63,10.82,2.89,29.42,28
CDM,RX-352372,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",583.0,291.5,141.24,792.88,32
CDM,RX-352399,UNCLASSIFIED DRUGS,88.0,44.0,26.4,119.68,26
CDM,RX-352404,"Influenza vaccine, inactivated",134.5,67.25,26.68,215.02,32
CDM,RX-352406,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",69.24,34.62,15.6,136.22,26
CDM,RX-352408,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",5.2,2.6,0.2,7.07,28
CDM,RX-352409,EPHEDRINE 5 MG/ML IV (RSI KIT),83.0,41.5,20.75,54.78,16
CDM,RX-352410,KETAMINE 50 MG/5 ML-0.9% NACL,78.69,39.34,19.67,51.93,16
CDM,RX-352411,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",15.16,7.58,0.23,20.62,28
CDM,RX-352412,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE (RSI KIT),71.66,35.83,17.92,47.3,16
CDM,RX-352413,"INJECTION, PROPOFOL, 10 MG",2.76,1.38,0.15,3.75,28
CDM,RX-352414,ROCURONIUM 50 MG/5 ML (10 MG/ML) (RSI KIT),88.84,44.42,22.21,58.64,16
CDM,RX-352415,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",97.78,48.89,29.33,132.98,26
CDM,RX-352416,BRIDION 200 MG/2 ML VIAL,363.24,181.62,90.81,239.74,16
CDM,RX-352435,ALPROSTADIL 20 MCG INTRACAVERNOSAL INJECTION (BUNDLED),19.58,9.79,4.89,12.92,16
CDM,RX-352484,"INJECTION, IFOSFAMIDE, 1 GRAM",291.5,145.75,40.99,396.44,28
CDM,RX-352485,"INJECTION, IFOSFAMIDE, 1 GRAM",269.685,134.845,40.99,434.95,28
CDM,RX-352496,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV (OR USE)",61.38,30.69,15.34,40.51,16
CDM,RX-352499,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",153.865,76.935,0.76,307.16,28
CDM,RX-352507,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.88,0.87,10.54,28
CDM,RX-352513,CENOBAMATE 12.5/25 MG DOSE PACK,10.25,5.12,2.56,6.76,16
CDM,RX-352659,"CYCLOSPORINE, ORAL, 100 MG",13.79,6.9,2.99,18.76,28
CDM,RX-352667,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG",96.31,39.245,18.2,2382.19,31
CDM,RX-352673,"INJECTION, MITOMYCIN, 5 MG",442.75,221.38,43.07,602.14,31
CDM,RX-352685,"INJECTION, METHADONE HCL, UP TO 10 MG",91.18,45.59,27.35,124.0,28
CDM,RX-352701,"INJECTION, TENECTEPLASE, 1 MG",552.54,276.27,165.76,5897.78,31
CDM,RX-352739,5% DEXTROSE/WATER (500 ML = 1 UNIT),62.315,31.16,2.89,140.08,28
CDM,RX-352757,"INJECTION, ATROPINE SULFATE, 0.01 MG",113.44,112.61,0.17,304.04,28
CDM,RX-352964,"INJECTION, CEFAZOLIN SODIUM, 500 MG",12.5,6.25,1.37,17.0,28
CDM,RX-352999,"INJECTION, CEFAZOLIN SODIUM, 500 MG",14.5,7.25,1.37,19.72,28
CDM,RX-353020,SODIUM CHLORIDE 1 GM TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-353027,"INJECTION, INSULIN, PER 5 UNITS",9.34,4.665,0.87,13.34,28
CDM,RX-353037,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",26.64,13.32,0.3,36.24,28
CDM,RX-353041,"INJECTION, INSULIN, PER 5 UNITS",1.38,0.69,0.41,1.88,28
CDM,RX-353043,UNCLASSIFIED DRUGS,64.29,32.14,19.29,87.43,26
CDM,RX-353065,"INJECTION, VASOPRESSIN, 1 UNIT",13.29,6.64,0.87,18.07,28
CDM,RX-353079,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",23.0,11.5,3.15,31.28,28
CDM,RX-353080,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",118.29,59.14,19.93,160.87,28
CDM,RX-353085,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",46.004999999999995,23.005000000000003,3.58,78.33,28
CDM,RX-353157,"HEPARIN 10,000 UNITS/500 ML PHOTOPHERESIS SOLUTION BAG",20.6,10.3,5.15,13.6,16
CDM,RX-353167,"INJECTION, INSULIN, PER 5 UNITS",24.01,12.01,0.87,32.65,28
CDM,RX-353168,"INJECTION, INSULIN, PER 5 UNITS",15.39,7.7,0.87,20.93,28
CDM,RX-353173,"INJECTION, BORTEZOMIB, 0.1 MG",334.27500000000003,167.13500000000002,2.19,962.55,32
CDM,RX-353178,"INJECTION, FENTANYL CITRATE, 0.1 MG",69.86,34.93,1.96,95.01,28
CDM,RX-353231,"INJECTION, INSULIN, PER 5 UNITS",19.0,9.5,0.87,25.84,28
CDM,RX-353234,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",202.0,101.0,4.59,274.72,28
CDM,RX-353278,SUFENTANIL 50 MCG/ML VIAL,87.0,43.5,21.75,57.42,16
CDM,RX-353299,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",221.0,110.5,1.09,233.0,28
CDM,RX-353328,ACETYLCHOLINE INTRACORONARY KIT PLACEHOLDER FOR PYXIS,110.0,55.0,27.5,72.6,16
CDM,RX-353345,"INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG",122.765,61.38,6.95,295.12,28
CDM,RX-353377,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",39.35,19.68,0.27,100.46,28
CDM,RX-353378,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.81,0.91,0.27,3.11,28
CDM,RX-353381,"INJECTION, DROPERIDOL, UP TO 5 MG",148.54000000000002,74.27,11.85,304.33,28
CDM,RX-353394,MINERAL OIL ENEMA - FOR DOSES LESS THAN 66 ML,15.9,7.95,3.98,10.5,16
CDM,RX-353399,"INJECTION, TENECTEPLASE, 1 MG",613.98,306.99,184.2,5897.78,31
CDM,RX-353400,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",416.94,208.47,121.68,567.04,31
CDM,RX-353426,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",254.24,127.12,76.27,1677.59,31
CDM,RX-353469,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",35.43,17.71,1.8,48.18,28
CDM,RX-353471,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",159.54500000000002,79.77,13.45,239.99,28
CDM,RX-353474,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",57.43,28.715,3.65,122.13,28
CDM,RX-353475,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.11,3.06,0.3,8.32,28
CDM,RX-353481,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",131.665,65.83500000000001,13.9,295.12,31
CDM,RX-353506,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",6.61,3.3,1.98,2382.19,31
CDM,RX-353507,LABETALOL 20 MG/4 ML INTRAVENOUS VIAL/SYRINGE BUNDLED,62.33,31.17,15.58,41.14,16
CDM,RX-353513,"INJECTION, INSULIN, PER 5 UNITS",11.34,5.67,0.87,15.43,28
CDM,RX-353546,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",197.67,98.83,37.98,268.83,28
CDM,RX-353560,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",28.0,14.0,8.4,38.08,28
CDM,RX-353580,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",595.75,297.88,121.68,810.22,31
CDM,RX-353605,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",128.32,64.16,20.92,162.0,32
CDM,RX-353647,"INJECTION, CEFAZOLIN SODIUM, 500 MG",18.94,9.47,1.37,25.75,28
CDM,RX-353649,AMIODARONE 900 MG/500 ML (1.8 MG/ML) IN NACL 0.9% IV BAG,79.0,39.5,19.75,52.14,16
CDM,RX-353654,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",12.36,6.18,0.76,16.81,28
CDM,RX-353655,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",13.355,6.675,0.76,27.2,28
CDM,RX-353697,"DEXAMETHASONE, ORAL, 0.25 MG",6.75,3.38,0.02,9.18,28
CDM,RX-353700,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",119.13,59.565,1.09,316.88,28
CDM,RX-355026,"AZATHIOPRINE, ORAL, 50 MG",24.0,12.0,0.1,32.64,28
CDM,RX-355046,"CABERGOLINE, ORAL, 0.25 MG",33.0,16.5,2.29,44.88,28
CDM,RX-355053,CARBAMAZEPINE 50 MG CHEWABLE (HALF-TAB),24.0,12.0,6.0,15.84,16
CDM,RX-355104,ENALAPRIL MALEATE 1.25 MG (HALF-TAB),13.0,6.5,3.25,8.58,16
CDM,RX-355149,HYDRALAZINE 12.5 MG (HALF-TAB),10.4,5.2,2.6,6.86,16
CDM,RX-355199,MEMANTINE 2.5 MG (HALF-TAB),23.0,11.5,5.75,15.18,16
CDM,RX-355245,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",11.5,5.75,0.02,15.64,28
CDM,RX-355398,CLONAZEPAM 0.125 MG (QUARTER-TAB),11.0,5.5,2.75,7.26,16
CDM,RX-355500,LEVOTHYROXINE 50 MCG (DYE-FREE),11.0,5.5,2.75,7.26,16
CDM,RX-355543,OXYCODONE 2.5 MG (HALF-TAB),11.58,5.79,2.9,7.64,16
CDM,RX-355641,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",32.85,16.42,9.85,44.67,28
CDM,RX-355662,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",23.0,11.5,0.48,31.28,28
CDM,RX-3565,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",55.714999999999996,27.855,1.44,108.29,28
CDM,RX-3597,CLONIDINE 0.1 MG/DAY PATCH,52.85,26.43,13.21,34.88,16
CDM,RX-3695,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",33.12,16.56,9.94,45.05,28
CDM,RX-3903,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",2.9000000000000004,1.4449999999999998,0.12,4.33,28
CDM,RX-3937,"INJECTION, PROTAMINE SULFATE, PER 10 MG",8.29,4.15,2.49,11.28,28
CDM,RX-3970,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",10.0,5.0,0.83,11.73,26
CDM,RX-3991,REMIFENTANIL 2 MG VIAL,303.42,151.71,75.86,200.26,16
CDM,RX-400043,UNCLASSIFIED DRUGS,17.17,8.58,3.17,25.85,26
CDM,RX-40312737,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",33.0,16.5,0.05,44.88,28
CDM,RX-4239,"MARCAINE 0.5%-EPI 1:200,000 VL",67.9,33.95,16.98,44.81,16
CDM,RX-4384,LOPERAMIDE 2 MG CAPSULE,11.35,5.675,0.68,13.2,16
CDM,RX-4426,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",10.775,5.390000000000001,2.95,13.38,28
CDM,RX-4470,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,20.0,10.0,5.0,13.2,16
CDM,RX-4533,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.7,0.85,0.25,2.31,28
CDM,RX-4572,"INJECTION, GLYCOPYRROLATE, 0.1 MG",9.055,4.53,0.58,15.62,28
CDM,RX-4580,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",67.0,33.5,4.64,91.12,28
CDM,RX-4644,CETIRIZINE 10 MG TABLET,15.24,7.62,2.62,13.2,16
CDM,RX-4679,ATORVASTATIN 10 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-471,"INJECTION, MITOMYCIN, 5 MG",529.975,264.985,43.07,709.89,31
CDM,RX-4753,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",577.495,288.745,174.0,4072.06,32
CDM,RX-49716,"INJECTION, FULVESTRANT, 25 MG",425.05,212.525,6.66,777.92,32
CDM,RX-4972,"INJECTION, VINBLASTINE SULFATE, 1 MG",23.380000000000003,11.690000000000001,6.99,114.92,28
CDM,RX-49806,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1353.435,676.72,281.79,2277.82,31
CDM,RX-49873,"INJECTION, TREPROSTINIL, 1 MG",62.79,31.4,18.84,604.48,31
CDM,RX-49874,"INJECTION, TREPROSTINIL, 1 MG",54.59,27.3,16.38,604.48,31
CDM,RX-49875,"INJECTION, TREPROSTINIL, 1 MG",49.56,24.78,14.87,604.48,31
CDM,RX-49879,"INJECTION, ENOXAPARIN SODIUM, 10 MG",229.0,114.5,0.87,309.15,28
CDM,RX-49880,"INJECTION, ENOXAPARIN SODIUM, 10 MG",225.09,112.55,0.87,308.48,28
CDM,RX-49881,"INJECTION, ENOXAPARIN SODIUM, 10 MG",223.4,111.7,0.87,308.18,28
CDM,RX-49882,"INJECTION, ENOXAPARIN SODIUM, 10 MG",219.67,109.83,0.87,316.88,28
CDM,RX-49883,"INJECTION, ENOXAPARIN SODIUM, 10 MG",221.92,110.96,0.87,309.63,28
CDM,RX-500024,SODIUM PHOSPHATE 0.116 MMOL/ML PERIPHERAL IV (NEO-PEDS),2.84,1.42,0.71,1.88,16
CDM,RX-500026,POTASSIUM PHOSPHATE 0.065  MMOL/ML PERIPHERAL IV (NEO-PEDS),2.38,1.19,0.6,1.57,16
CDM,RX-500031,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",31.39,15.7,0.2,42.69,28
CDM,RX-500513,AMPICILLIN 100 MG/ML IV PUSH INJECTION (PEDS ED/OR) - DOSE <= 250 MG,56.0,28.0,14.0,36.96,16
CDM,RX-50178,"INJECTION, VORICONAZOLE, 10 MG",4.27,2.13,1.24,5.81,28
CDM,RX-5034,DANTROLENE 20 MG INTRAVENOUS SOLUTION,186.25,93.13,46.56,122.93,16
CDM,RX-50763,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,76.17,38.09,19.04,50.27,16
CDM,RX-50811,Rabies vaccine for injection into muscle,463.15500000000003,231.575,34.8,1823.64,31
CDM,RX-5082,AZITHROMYCIN 250 MG TABLET,357.0,178.5,89.25,235.62,16
CDM,RX-5085,CLONIDINE 0.2 MG/DAY PATCH,65.46,32.73,16.36,43.2,16
CDM,RX-51363,"Pneumococcal vaccine, 23-valent",291.0,145.5,26.68,395.76,32
CDM,RX-51397,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",133.815,66.91,15.1,295.12,28
CDM,RX-51443,DEXTROSE 50%-WATER SYRINGE,64.0,32.0,12.23,43.98,16
CDM,RX-51450,DEXTROSE 50%-WATER VIAL,53.16,26.58,13.29,35.09,16
CDM,RX-51503,5% DEXTROSE/WATER (500 ML = 1 UNIT),21.72,10.86,2.89,170.68,28
CDM,RX-51504,DEXTROSE 10%-WATER IV SOLUTION,50.725,25.365000000000002,5.12,53.45,16
CDM,RX-51633,"INJECTION, DIAZEPAM, UP TO 5 MG",217.0,108.5,11.04,295.12,28
CDM,RX-51760,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,98.94999999999999,49.474999999999994,23.76,64.61,16
CDM,RX-51813,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",47.14,23.57,11.17,157.12,28
CDM,RX-5183,ASPIRIN 325 MG TABLET,10.99,5.49,2.75,7.25,16
CDM,RX-51843,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",111.155,55.575,1.24,295.12,31
CDM,RX-51844,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",5.32,2.66,1.24,306.0,31
CDM,RX-51847,"INJECTION, ENOXAPARIN SODIUM, 10 MG",220.96,110.48,0.87,295.12,28
CDM,RX-51848,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",72.68,36.34,19.41,314.55,31
CDM,RX-51849,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",112.155,56.08,7.07,239.99,31
CDM,RX-51857,AZITHROMYCIN 500 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-51877,"HYALURONAN OR DERIVATIVE, HYALGAN, SUPARTZ OR VISCO-3, FOR INTRA-ARTICULAR INJECTION, PER DOSE",763.0,381.5,120.4,1037.68,32
CDM,RX-51884,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,224.29,112.14,0.71,164.76,16
CDM,RX-51894,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",225.0,112.5,0.12,306.0,28
CDM,RX-52174,LEXAPRO 10 MG TABLET,13.79,6.9,3.45,9.1,16
CDM,RX-52240,"INJECTION, RASBURICASE, 0.5 MG",1771.19,885.59,309.0,2414.98,31
CDM,RX-52327,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",573.57,286.52,233.44,2277.82,31
CDM,RX-52711,PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLUTION,224.11,112.06,56.03,2187.29,16
CDM,RX-52834,EZETIMIBE 10 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-5410,DUOVISC VISCOELASTIC SYSTEM,501.72,250.86,125.43,331.14,16
CDM,RX-54453,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",23.55,11.77,7.06,32.03,28
CDM,RX-54454,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 6 MG, BUT LESS THAN OR EQUAL TO 10 MG BUPRENORPHINE",32.77,16.38,9.83,44.56,28
CDM,RX-54846,"INJECTION, METHOTREXATE SODIUM, 50 MG",26.89,13.44,1.34,292.95,28
CDM,RX-54871,CYCLOBENZAPRINE 5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-54978,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",580.0,290.0,183.28,1775.36,31
CDM,RX-550001,DEXTROSE 12.5% WATER IV SOLN (PEDS-NEO),103.0,51.5,25.75,67.98,16
CDM,RX-550002,DEXTROSE 15% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
CDM,RX-550003,DEXTROSE 20%-WATER IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-550007,DEXTROSE 25% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
CDM,RX-550011,DEXTROSE 7.5% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
CDM,RX-550020,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",26.82,13.41,0.76,36.47,28
CDM,RX-550021,"INJECTION, MEROPENEM, 100 MG",8.88,4.44,0.63,12.07,28
CDM,RX-550030,SODIUM CHLORIDE 0.45% SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-550032,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",103.0,51.5,2.13,140.08,28
CDM,RX-550037,DEXTROSE 5%-0.45% NACL IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-550039,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",1.7,0.85,0.2,2.31,28
CDM,RX-550040,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),25.75,12.88,2.16,35.02,28
CDM,RX-550041,"5% DEXTROSE IN LACTATED RINGERS INFUSION, UP TO 1000 CC",103.0,51.5,8.14,140.08,28
CDM,RX-550043,DEXTROSE 10%-WATER IV SOLUTION,103.0,51.5,25.75,67.98,16
CDM,RX-550044,5% DEXTROSE/WATER (500 ML = 1 UNIT),103.0,51.5,2.89,140.08,28
CDM,RX-550046,"INJECTION, EPINEPHRINE (BPI), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",3.61,1.8,1.08,4.91,28
CDM,RX-550052,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",91.2,45.6,0.05,124.03,28
CDM,RX-550059,"Haemophilus influenzae type b vaccine, PRP-T conjugate",107.5,53.75,26.68,129.2,32
CDM,RX-550063,"INJECTION, LEVOCARNITINE, PER 1 GM",52.81,26.41,15.84,71.83,28
CDM,RX-550066,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",3.56,1.78,0.36,4.84,28
CDM,RX-550081,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",7.33,3.67,0.36,9.97,28
CDM,RX-550089,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
CDM,RX-550094,CLONIDINE 0.1 MG/DAY PATCH,54.0,27.0,13.5,35.64,16
CDM,RX-550097,"INJECTION, MICAFUNGIN SODIUM, 1 MG",2.05,1.03,0.41,2.79,28
CDM,RX-550110,CIPROFLOX-DEXAMETH OTIC SUSP,284.0,142.0,71.0,187.44,16
CDM,RX-550128,"INJECTION, CEFAZOLIN SODIUM, 500 MG",56.0,28.0,1.37,76.16,28
CDM,RX-550133,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",68.0,34.0,0.23,92.48,28
CDM,RX-550138,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION (NEO-PEDS),5313.25,2656.63,1328.31,3506.75,16
CDM,RX-550139,PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION (NEO-PEDS),3491.66,1745.83,872.92,2304.5,16
CDM,RX-550152,POLYETHYLENE GLYCOL-ELECTROLYTE (GOLYTELY) SOLUTION (PEDS),82.0,41.0,20.5,54.12,16
CDM,RX-550156,SODIUM CHLORIDE 0.9% IRRIG.,103.0,51.5,25.75,67.98,16
CDM,RX-550179,"INJECTION, VASOPRESSIN, 1 UNIT",9.4,4.7,0.87,12.78,28
CDM,RX-550182,NUTRILIPID 20% IV FAT EMULSION,105.5,52.75,26.38,69.63,16
CDM,RX-550210,SODIUM CHLORIDE 3% IV SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-550228,"INJECTION, ACETAMINOPHEN (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0131, 10 MG",47.99,24.0,0.1,65.27,28
CDM,RX-550244,VALPROATE SODIUM 20 MG/ML INJECTION (NEO-PEDS),6.45,3.23,1.61,4.26,16
CDM,RX-550257,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",493.19,246.6,121.68,670.74,31
CDM,RX-550260,AMPICILLIN 100 MG/ML IV PUSH INJECTION (PEDS ED/OR) - DOSE > 250 MG,30.7,15.35,7.68,20.26,16
CDM,RX-550267,"INJECTION, AMPICILLIN SODIUM, 500 MG",57.86,28.93,0.97,78.69,28
CDM,RX-55152,"APREPITANT, ORAL, 5 MG",14.77,7.38,4.43,20.09,28
CDM,RX-55153,"APREPITANT, ORAL, 5 MG",15.44,7.72,4.57,21.0,28
CDM,RX-552,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",217.0,108.5,1.09,295.12,28
CDM,RX-55413,"INJECTION, ZOLEDRONIC ACID, 1 MG",1099.25,549.63,8.38,1643.46,28
CDM,RX-55572,"INJECTION, AGALSIDASE BETA, 1 MG",502.64,251.32,150.79,9401.8,31
CDM,RX-55797,"INJECTION, LEVOFLOXACIN, 250 MG",74.96000000000001,37.480000000000004,3.56,103.19,28
CDM,RX-55798,"INJECTION, LEVOFLOXACIN, 250 MG",51.35,25.675,3.56,69.63,28
CDM,RX-55815,"MARCAINE 0.5%-EPI 1:200,000 VL",49.96,24.98,12.49,32.97,16
CDM,RX-55817,"MARCAINE 0.25%-EPI 1:200,000",45.5,22.75,11.37,30.03,16
CDM,RX-55819,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",233.0,116.5,0.02,316.88,28
CDM,RX-55825,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,2.55,1.27,0.64,1.68,16
CDM,RX-56022,NEO-SYNEPHRINE 0.5% SPRAY,37.55,18.78,9.56,27.16,16
CDM,RX-56108,DEEP SEA 0.65% NOSE SPRAY,10.0,5.0,2.5,6.6,16
CDM,RX-56828,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",2.4,1.2,0.2,10.54,28
CDM,RX-56854,ARIPIPRAZOLE 5 MG TABLET,228.58,114.29,57.15,150.87,16
CDM,RX-5705,"CYCLOSPORINE, ORAL, 25 MG",6.69,3.35,0.87,9.1,28
CDM,RX-57085,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",39.0,19.5,11.7,604.48,31
CDM,RX-57086,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",33.35,16.675,8.31,604.48,31
CDM,RX-57093,"INJECTION, PALONOSETRON HCL, 25 MCG",38.9,19.45,0.58,52.9,28
CDM,RX-57096,ROSUVASTATIN 20 MG TABLET,58.0,29.0,14.5,38.28,16
CDM,RX-57157,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",15.3,7.65,4.59,20.81,28
CDM,RX-57205,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",7.35,3.67,0.71,9.99,28
CDM,RX-57286,"INJECTION, CARBOPLATIN, 50 MG",72.86,36.43,4.83,236.03,28
CDM,RX-57603,MELATONIN 1 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-57774,WHITE PETROLATUM 41 % TOPICAL OINTMENT,37.65,18.83,9.41,24.85,16
CDM,RX-5799,"INJECTION, METHADONE HCL, UP TO 10 MG",81.28,40.64,24.38,110.54,28
CDM,RX-5886,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",10.0,5.0,2.5,6.6,16
CDM,RX-58962,MEMANTINE HCL 5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-59290,METOPROLOL TARTRATE 25 MG TABLET,8.68,4.34,1.25,7.64,16
CDM,RX-59572,HYDROCODONE-ACETAMN 7.5-325/15,1.52,0.76,0.38,1.01,16
CDM,RX-59581,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",306.18,78.88,2.8,1677.59,31
CDM,RX-59591,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",12.36,6.18,3.09,8.16,16
CDM,RX-59764,"INJECTION, BEVACIZUMAB, 10 MG",370.605,185.3,98.06,2382.19,31
CDM,RX-5980,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",2.99,1.49,0.36,121.9,28
CDM,RX-59810,"MYCOPHENOLIC ACID, ORAL, 180 MG",20.64,10.32,0.53,28.08,28
CDM,RX-59811,"MYCOPHENOLIC ACID, ORAL, 180 MG",13.58,6.79,0.53,18.47,28
CDM,RX-600001,FLUCONAZOLE IN NACL 2 MG/ML INJECTION (PEDS),155.0,77.5,38.75,102.3,16
CDM,RX-600005,"INJECTION, LINEZOLID, 200 MG",44.25,22.13,4.52,60.18,28
CDM,RX-600007,"INJECTION, FUROSEMIDE, 1 MG",4.28,2.14,0.03,5.83,28
CDM,RX-600008,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",16.48,8.24,0.27,22.42,28
CDM,RX-600009,"Measles, mumps, and rubella vaccine",220.5,110.25,26.68,397.12,32
CDM,RX-600019,MIDAZOLAM 2MG/ML SOLUTION (PEDS),36.38,18.19,9.09,24.01,16
CDM,RX-600038,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.81,12.9,7.74,35.1,26
CDM,RX-600047,SUCRALFATE 100MG/ML SUSPENSION (PEDS),30.73,15.36,7.68,20.28,16
CDM,RX-600051,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",237.16,118.58,53.49,1286.64,31
CDM,RX-600089,FLEET PEDIA-LAX ENEMA,9.89,4.95,2.47,6.53,16
CDM,RX-600101,ACETYLCYSTEINE 20% VIAL,54.85,27.42,13.71,36.2,16
CDM,RX-600113,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",32.04,16.02,9.61,43.57,28
CDM,RX-600118,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",129.25,64.63,38.78,175.78,28
CDM,RX-600125,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",46.0,23.0,0.27,62.56,28
CDM,RX-600127,PANTOPRAZOLE 0.4 MG/ML INJECTION DILUTION (PEDS),3.06,1.53,0.77,2.02,16
CDM,RX-600133,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",30.0,15.0,0.87,40.8,28
CDM,RX-600134,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",360.65,180.33,87.58,490.49,31
CDM,RX-600135,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",332.76,166.38,87.58,452.56,31
CDM,RX-600145,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",39.0,19.5,4.95,154.11,32
CDM,RX-600146,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE (PEDS),101.0,50.5,25.25,66.66,16
CDM,RX-600148,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",63.23,31.62,1.17,316.88,28
CDM,RX-600149,"INJECTION, ENOXAPARIN SODIUM, 10 MG",15.94,7.97,0.87,21.68,28
CDM,RX-600150,"INJECTION, ENOXAPARIN SODIUM, 10 MG",10.5,5.25,0.87,14.28,28
CDM,RX-600151,"INJECTION, ENOXAPARIN SODIUM, 10 MG",10.71,5.36,0.87,14.57,28
CDM,RX-600152,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",133.945,66.97,0.71,307.21,28
CDM,RX-600158,"INJECTION, FAMOTIDINE, 0.25 MG",1.66,0.83,0.02,2.26,28
CDM,RX-600159,"INJECTION, FENTANYL CITRATE, 0.1 MG",64.0,32.0,1.96,87.04,28
CDM,RX-600166,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",63.89,31.94,7.24,86.89,28
CDM,RX-600172,KETAMINE 50 MG/5 ML-0.9% NACL,110.23,55.12,27.56,72.75,16
CDM,RX-600173,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",140.475,70.24,0.54,306.0,27
CDM,RX-600174,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",130.84,65.42,0.54,316.88,27
CDM,RX-600176,LIDOCAINE 1% INJECTION (PEDS),2.17,1.08,0.54,1.43,16
CDM,RX-600178,"INJECTION, LORAZEPAM, 2 MG",141.53,70.765,2.33,295.12,28
CDM,RX-600179,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",46.63,23.31,0.23,63.41,28
CDM,RX-600181,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",75.15,37.58,5.02,102.21,28
CDM,RX-600186,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",7.9399999999999995,3.9699999999999998,0.15,11.94,28
CDM,RX-600190,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",45.5,22.75,4.64,61.88,28
CDM,RX-600193,"INJECTION, PYRIDOXINE HCL, 100 MG",78.0,39.0,23.4,106.08,28
CDM,RX-600194,ROCURONIUM 10MG/ML INJECTION (PEDS),59.44,29.72,14.86,39.23,16
CDM,RX-600195,SODIUM BICARBONATE 8.4% VIAL,80.27,40.14,20.07,52.98,16
CDM,RX-600241,ISONIAZID 10MG/ML ORAL SOLUTION OR SYRUP  (PEDS),3.57,1.79,0.89,2.36,16
CDM,RX-600249,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",24.69,12.35,0.68,33.58,28
CDM,RX-600257,"PREDNISOLONE ORAL, PER 5 MG",5.74,2.87,1.52,7.81,28
CDM,RX-600259,RISPERIDONE 1 MG/ML SYRUP (PEDS),24.0,12.0,6.0,15.84,16
CDM,RX-600266,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",37.85,18.92,11.35,51.47,28
CDM,RX-600476,STOMATITIS COCKTAIL (PEDS),58.0,29.0,14.5,38.28,16
CDM,RX-600504,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",57.06,28.53,1.78,77.61,28
CDM,RX-600506,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",102.4,51.2,30.72,139.26,28
CDM,RX-600511,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",89.86,44.93,19.78,160.37,28
CDM,RX-600512,"INJECTION, LEVETIRACETAM, 10 MG",5.04,2.52,0.07,6.85,28
CDM,RX-600529,LABETALOL 40 MG/ML ORAL COMPOUND SUSPENSION (PEDS),9.0,4.5,2.25,5.94,16
CDM,RX-600530,"INJECTION, INSULIN, PER 5 UNITS",37.0,18.5,0.87,50.32,28
CDM,RX-600532,UNCLASSIFIED BIOLOGICS,6.08,3.04,1.82,8.27,26
CDM,RX-600533,"TEMOZOLOMIDE, ORAL, 5 MG",43.46,21.73,0.89,59.11,28
CDM,RX-600539,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",82.0,41.0,18.13,111.52,28
CDM,RX-600543,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",1.19,0.59,0.03,1.62,28
CDM,RX-600545,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",32.67,16.34,5.02,44.44,28
CDM,RX-600548,EPINEPHRINE 100 MCG/10 ML-D5W,75.59,37.79,18.9,49.89,16
CDM,RX-600553,HEPARIN 50 UNITS/5 ML (10/ML),18.41,9.21,4.6,12.15,16
CDM,RX-600554,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",16.2,8.1,0.03,22.03,28
CDM,RX-600555,HEPARIN 50 UNITS/5 ML (10/ML),20.34,10.17,5.08,13.42,16
CDM,RX-600556,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",10.97,5.49,0.03,14.92,28
CDM,RX-600562,HYDROXYZINE 10 MG/5 ML SYRUP (PEDS),2.82,1.41,0.7,1.86,16
CDM,RX-600567,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",15.27,7.64,0.03,20.77,28
CDM,RX-600571,CALCIUM CHLORIDE 10 % INJECTION (PEDS),82.33,41.17,20.58,54.34,16
CDM,RX-600574,"INJECTION, ATROPINE SULFATE, 0.01 MG",15.76,7.88,0.17,21.43,28
CDM,RX-600600,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",85.88,42.94,25.76,116.8,28
CDM,RX-600615,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",26.5,13.25,0.76,36.04,28
CDM,RX-600622,"INJECTION, PROPOFOL, 10 MG",18.25,9.13,0.15,24.83,28
CDM,RX-600629,HYDROCODONE-ACETAMN 7.5-325/15,30.2,15.1,7.55,19.93,16
CDM,RX-600638,"INJECTION, COSYNTROPIN, 0.25 MG",154.0,77.0,34.07,209.44,28
CDM,RX-600640,"LIDOCAINE 1%, BUFFERED",216.6,108.3,16.5,142.96,16
CDM,RX-600642,GLUCOSE TOLERANCE TEST 0.33 G/ML ORAL SOLUTION (PEDS),12.36,6.18,3.09,8.16,16
CDM,RX-600681,"INJECTION, CEFAZOLIN SODIUM, 500 MG",135.87,67.93,1.37,184.78,28
CDM,RX-600682,CLINDAMYCIN 600 MG/50 ML-D5W,155.0,77.5,38.75,102.3,16
CDM,RX-600685,"INJECTION, METRONIDAZOLE, 10 MG",152.45,76.23,0.05,207.33,28
CDM,RX-600686,AMPICILLIN-SULBACTAM 1-0.5 GM INJECTION (PEDS),58.75,29.38,14.69,38.78,16
CDM,RX-600687,"INJECTION, AMPICILLIN SODIUM, 500 MG",28.9,14.45,0.97,39.31,28
CDM,RX-600688,"INJECTION, AMPICILLIN SODIUM, 500 MG",15.5,7.75,0.97,21.08,28
CDM,RX-600689,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",60.03,30.02,2.19,81.65,28
CDM,RX-600690,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",33.0,16.5,2.19,44.88,28
CDM,RX-600696,"INJECTION, MEROPENEM, 100 MG",7.04,3.52,0.63,9.58,28
CDM,RX-600700,"INJECTION, CEFAZOLIN SODIUM, 500 MG",27.67,13.83,1.37,37.63,28
CDM,RX-600701,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.31,15.65,1.44,42.58,28
CDM,RX-600702,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",18.48,9.24,1.44,25.13,28
CDM,RX-600703,"INJECTION, CEFTAZIDIME, PER 500 MG",31.5,15.75,2.43,42.84,28
CDM,RX-600704,"INJECTION, CEFTAZIDIME, PER 500 MG",16.75,8.38,2.43,22.78,28
CDM,RX-600705,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",11.3,5.65,0.05,15.37,28
CDM,RX-600711,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",5.48,2.74,0.05,7.45,28
CDM,RX-600719,"INJECTION, INSULIN, PER 5 UNITS",12.68,6.34,0.87,17.25,28
CDM,RX-600723,TRANEXAMIC ACID 100 MG/ML IV (PEDS),61.0,30.5,15.25,40.26,16
CDM,RX-600731,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",2.42,1.21,0.18,3.29,28
CDM,RX-600747,ALBUTEROL 2.5 MG/0.5 ML SOL,8.54,4.27,2.14,5.64,16
CDM,RX-600749,"INJECTION, ACETAMINOPHEN (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0131, 10 MG",1.75,0.87,0.1,2.38,28
CDM,RX-600752,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",14.15,7.07,0.23,19.24,28
CDM,RX-600767,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",14.15,7.08,0.76,19.25,28
CDM,RX-600775,"INJECTION, ATROPINE SULFATE, 0.01 MG",3.91,1.95,0.17,5.32,28
CDM,RX-600793,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",219.5,109.75,65.85,1677.59,31
CDM,RX-600794,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",233.355,116.675,62.7,1677.59,31
CDM,RX-600795,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",203.73,101.86,61.12,1677.59,31
CDM,RX-600796,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",201.1,100.55,60.33,1677.59,31
CDM,RX-600805,"INJECTION, ENOXAPARIN SODIUM, 10 MG",124.455,62.225,0.87,292.95,28
CDM,RX-600815,FAT EMULSION (SMOFLIPID) 20% IV BAG (NEO/PEDS),155.0,77.5,38.75,102.3,16
CDM,RX-600822,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",28.43,14.22,1.73,38.67,28
CDM,RX-600826,"INJECTION, CEFAZOLIN SODIUM, 500 MG",143.93,71.96,1.37,195.74,28
CDM,RX-600839,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
CDM,RX-600842,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",85.0,42.5,0.12,115.6,28
CDM,RX-600849,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",71.2,35.6,0.68,96.83,28
CDM,RX-600850,FAMOTIDINE 2 MG/ML INJECTION DILUTION (PEDS),13.64,6.82,3.41,9.0,16
CDM,RX-600851,"INJECTION, ATROPINE SULFATE, 0.01 MG",1.54,0.77,0.17,2.09,28
CDM,RX-600885,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",17.17,8.59,1.8,23.36,28
CDM,RX-600886,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",46.56,23.28,1.8,63.32,28
CDM,RX-600894,"INJECTION, INFLIXIMAB-DYYB (ZYMFENTRA), 10 MG",225.5,112.75,67.65,306.68,28
CDM,RX-600894,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",235.08,117.54,39.96,1286.64,31
CDM,RX-600910,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",129.31,64.66,4.59,175.87,28
CDM,RX-600916,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",109.66,54.83,0.56,295.12,31
CDM,RX-600931,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",2.07,1.04,0.56,154.11,31
CDM,RX-6073,POTASSIUM ACET 40 MEQ/20 ML VL,20.89,10.44,5.22,13.79,16
CDM,RX-6109,SODIUM ACETATE 100 MEQ/50 ML,43.78,21.89,10.95,28.9,16
CDM,RX-6188,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",28.7,14.35,7.16,604.48,31
CDM,RX-63115,"INJECTION, OLANZAPINE, 0.5 MG",221.0,110.5,1.34,309.15,28
CDM,RX-63435,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",221.0,110.5,4.08,304.45,28
CDM,RX-63482,MIRTAZAPINE 7.5 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-63553,"INJECTION, ACETYLCYSTEINE, 100 MG",6.029999999999999,3.0149999999999997,0.61,12.61,28
CDM,RX-6359,CEPHALEXIN 250 MG CAPSULE,20.0,10.0,5.0,13.2,16
CDM,RX-63810,"INJECTION, AGALSIDASE BETA, 1 MG",502.64,251.32,150.79,9401.8,31
CDM,RX-63828,"MAGNESIUM L-LACTATE ER 84 MG TABLET,EXTENDED RELEASE",11.06,5.53,2.77,7.3,16
CDM,RX-6405,HYDROCODONE-ACETAMIN 5-325 MG,21.18,10.59,3.71,18.84,16
CDM,RX-6468,NITROGLYCERIN 0.2 MG/HR PATCH,11.35,5.68,2.84,7.49,16
CDM,RX-64956,"INJECTION, AZACITIDINE, 1 MG",287.235,143.62,0.76,755.78,32
CDM,RX-650000,"INJECTION, ACYCLOVIR, 5 MG",6.05,3.02,0.2,8.22,28
CDM,RX-650005,"INJECTION, CEFTAZIDIME, PER 500 MG",36.11,18.06,2.43,49.11,28
CDM,RX-650008,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",66.8,33.4,3.58,90.85,28
CDM,RX-650017,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",18.5,9.25,0.05,25.16,28
CDM,RX-650145,"INJECTION, FENTANYL CITRATE, 0.1 MG",99.0,49.5,1.96,134.64,28
CDM,RX-650169,5% DEXTROSE/WATER (500 ML = 1 UNIT),103.0,51.5,2.89,140.08,28
CDM,RX-650170,DEXTROSE 10%-WATER IV SOLUTION,103.0,51.5,25.75,67.98,16
CDM,RX-650174,SODIUM CHLORIDE 0.45% SOLN,103.0,51.5,25.75,67.98,16
CDM,RX-65232,ASTHMANEFRIN RFILL 2.25% SOLN,16.715,8.355,4.15,11.11,16
CDM,RX-65233,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",5.22,2.6100000000000003,0.43,10.66,28
CDM,RX-6539,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",6.87,3.44,0.25,9.35,28
CDM,RX-6575,"INJECTION, DAUNORUBICIN, 10 MG",381.84499999999997,190.92,23.52,759.58,32
CDM,RX-6581,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",68.66,34.33,13.98,302.77,28
CDM,RX-6584,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",30.0,15.0,9.0,40.8,28
CDM,RX-6590,"INJECTION FLUCONAZOLE, 200 MG",76.14,38.07,7.39,103.55,28
CDM,RX-6645,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",12.51,6.25,1.29,17.01,28
CDM,RX-6657,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",16.52,8.26,0.48,22.47,28
CDM,RX-66599,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",13.33,6.67,3.33,8.8,16
CDM,RX-67092,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",402.28,201.14,120.68,547.09,28
CDM,RX-67374,FENTANYL 2 MCG-BUP 0.0625%-NS,154.99,77.5,38.75,102.3,16
CDM,RX-6772,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",109.95,54.975,0.12,295.12,28
CDM,RX-67745,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",7.4,3.7,1.45,10.06,28
CDM,RX-67782,LACTULOSE 20 GM/30 ML SOLN CUP,30.0,15.0,7.5,19.8,16
CDM,RX-67787,"INJECTION, NATALIZUMAB, 1 MG",76.88,38.44,23.06,5897.78,31
CDM,RX-68115,"INJECTION, OXYTOCIN, UP TO 10 UNITS",47.19,23.6,4.44,64.18,28
CDM,RX-68123,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",77.5,38.75,0.05,105.4,28
CDM,RX-68171,"INJECTION, ZICONOTIDE, 1 MICROGRAM",90.4,45.2,17.44,1677.59,31
CDM,RX-6820,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,6.695,3.3449999999999998,1.69,4.37,16
CDM,RX-68219,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",65.845,32.92,13.5,1677.59,31
CDM,RX-684,FUROSEMIDE 40 MG TABLET,11.18,5.59,3.0,8.16,16
CDM,RX-68456,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",980.365,490.18500000000006,281.79,1892.54,31
CDM,RX-68581,"VITAMIN A PALMITATE 50,000 UNIT/ML INTRAMUSCULAR SOLUTION",665.0,332.5,166.25,438.9,16
CDM,RX-68713,"INJECTION, MICAFUNGIN SODIUM, 1 MG",2.12,1.06,0.41,2.88,28
CDM,RX-6897,SUCRALFATE 100 MG/ML ORAL SUSPENSION,70.0,35.0,17.5,46.2,16
CDM,RX-69123,FENTANYL 12 MCG/HR PATCH,46.04,23.02,11.51,30.39,16
CDM,RX-69198,"INJECTION, OXALIPLATIN, 0.5 MG",71.125,35.56,0.08,97.03,28
CDM,RX-69308,"INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG",18.11,9.06,5.43,24.64,28
CDM,RX-6933,"INJECTION, ACYCLOVIR, 5 MG",1.5,0.75,0.2,2.04,28
CDM,RX-69352,"INJECTION, TIGECYCLINE, 1 MG",4.36,2.18,0.92,5.93,28
CDM,RX-69425,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",163.085,81.53999999999999,38.93,604.48,31
CDM,RX-69718,PREGABALIN 25 MG CAPSULE,30.0,15.0,7.5,19.8,16
CDM,RX-69720,LYRICA 75 MG CAPSULE,21.82,10.91,5.45,14.4,16
CDM,RX-700000,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",361.0,180.5,87.58,490.96,31
CDM,RX-700001,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",361.0,180.5,87.58,490.96,31
CDM,RX-700002,"INJECTION FLUCONAZOLE, 200 MG",155.0,77.5,7.39,210.8,28
CDM,RX-700006,"INJECTION, METRONIDAZOLE, 10 MG",155.0,77.5,0.05,210.8,28
CDM,RX-700011,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",129.0,64.5,38.7,175.44,28
CDM,RX-700017,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.96,1.98,0.12,5.38,28
CDM,RX-700029,BUDESONIDE 0.25 MG/2 ML SUSP,31.39,15.69,7.85,20.72,16
CDM,RX-700036,CEPHALEXIN 250 MG/5 ML SUSP,23.0,11.5,5.75,15.18,16
CDM,RX-700049,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",24.56,12.28,0.18,33.4,28
CDM,RX-700072,"INJECTION, FUROSEMIDE, 1 MG",32.83,16.42,0.03,44.65,28
CDM,RX-700075,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",56.33,28.17,3.58,76.61,28
CDM,RX-700081,Hepatitis B immune globulin for injection into muscle,878.0,439.0,227.42,1286.64,31
CDM,RX-700083,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",122.635,61.315,0.59,316.88,28
CDM,RX-700085,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",67.33,33.67,7.24,91.57,28
CDM,RX-700086,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",535.83,267.92,78.03,2382.19,31
CDM,RX-700091,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",1.76,0.88,0.08,2.39,28
CDM,RX-700096,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",26.92,13.46,0.27,36.62,28
CDM,RX-7001,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",6.895,3.45,0.68,14.3,28
CDM,RX-700121,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",142.07999999999998,71.03999999999999,4.64,292.95,28
CDM,RX-700127,"PREDNISOLONE ORAL, PER 5 MG",12.0,6.0,1.52,16.32,28
CDM,RX-700137,SODIUM BICARBONATE 0.5MEQ/ML INJECTION (NEO),73.73,36.87,18.43,48.66,16
CDM,RX-700179,SODIUM CHLORIDE 4 MEQ/ML INJECTION (NEO),46.74,23.37,11.68,30.85,16
CDM,RX-700185,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION (NEO),89.12,44.56,22.28,58.82,16
CDM,RX-700190,"INJECTION, AMPICILLIN SODIUM, 500 MG",56.83,28.42,0.97,77.29,28
CDM,RX-700191,"INJECTION, CAFFEINE CITRATE, 5 MG",25.92,12.96,3.35,35.25,28
CDM,RX-700196,"INJECTION, AMPICILLIN SODIUM, 500 MG",57.09,28.55,0.97,77.65,28
CDM,RX-700198,ALBUTEROL 2.5 MG/0.5 ML SOL,9.62,4.81,2.41,6.35,16
CDM,RX-700199,ALBUTEROL SUL 2.5 MG/3 ML SOLN,8.32,4.16,2.08,5.49,16
CDM,RX-700200,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",11.08,5.54,0.66,15.07,28
CDM,RX-700211,"INJECTION, GLYCOPYRROLATE, 0.1 MG",37.89,18.95,0.58,51.54,28
CDM,RX-700219,POTASSIUM PHOSPHATE 4.4 MEQ/ML (CRRT) INJECTION (NEO),96.0,48.0,24.0,63.36,16
CDM,RX-700228,LABETALOL 2.5 MG/ML NACL 0.9% INJECTION DILUTION (NEO),39.25,19.63,9.81,25.91,16
CDM,RX-700232,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.97,2.98,0.03,8.12,28
CDM,RX-700239,"INJECTION, COSYNTROPIN, 0.25 MG",70.0,35.0,21.0,95.2,28
CDM,RX-700244,INDOMETHACIN 0.1 MG/ML INJECTION DILUTION (NEO),129.0,64.5,32.25,85.14,16
CDM,RX-700249,ROCURONIUM IN NS 2 MG/ML INJECTION DILUTION (NEO),69.0,34.5,17.25,45.54,16
CDM,RX-700257,"INJECTION, BEVACIZUMAB, 10 MG",237.0,118.5,71.1,2382.19,31
CDM,RX-700261,"INJECTION, ENOXAPARIN SODIUM, 10 MG",71.0,35.5,0.87,96.56,28
CDM,RX-700273,NUTRILIPID 20% IV FAT EMULSION,99.3,49.65,24.82,65.54,16
CDM,RX-700282,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.05,2.53,0.03,6.87,28
CDM,RX-700290,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",86.0,43.0,0.71,116.96,28
CDM,RX-700303,OMEGA-3 FATTY ACID 10% - (NEO-PEDS),5.56,2.78,1.39,3.67,16
CDM,RX-700312,FAT EMULSION (SMOFLIPID) 20% SYRINGE (NEO/PEDS),149.97,74.99,37.49,98.98,16
CDM,RX-700314,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",71.0,35.5,21.3,96.56,28
CDM,RX-700323,"INJECTION, FENTANYL CITRATE, 0.1 MG",99.0,49.5,1.96,134.64,28
CDM,RX-700339,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",66.0,33.0,0.23,89.76,28
CDM,RX-700340,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",67.5,33.75,5.02,91.8,28
CDM,RX-70111,TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,248.63,124.32,62.16,164.1,16
CDM,RX-7017,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",12.190000000000001,6.09,1.29,15.51,28
CDM,RX-70189,CHLORHEXIDINE 0.12% RINSE,15.68,7.84,3.92,10.35,16
CDM,RX-70308,SODIUM CHLORIDE 0.9% 50 ML,101.84,50.92,5.38,82.83,16
CDM,RX-70457,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",74.3,37.15,5.41,108.7,31
CDM,RX-70531,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,5668.0,2834.0,1417.0,3740.88,16
CDM,RX-70532,PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,3032.0,1516.0,758.0,2001.12,16
CDM,RX-7064,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",1.42,0.71,0.02,13.6,28
CDM,RX-7073,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",13.105,6.55,0.15,26.44,28
CDM,RX-70797,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",7.89,3.95,0.66,10.73,28
CDM,RX-70798,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.09,3.04,0.25,8.28,28
CDM,RX-70854,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",155.76,77.88,46.73,2382.19,31
CDM,RX-71102,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",1.04,0.52,0.03,1.85,28
CDM,RX-71103,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",11.495000000000001,5.75,0.03,15.68,28
CDM,RX-71119,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",57.0,28.5,0.3,77.52,28
CDM,RX-71430,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",4.47,2.23,0.59,6.07,28
CDM,RX-7176,"INJECTION, LORAZEPAM, 2 MG",60.0,30.0,2.33,231.1,28
CDM,RX-71785,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",114.47999999999999,57.235,0.08,314.55,28
CDM,RX-71788,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",4.68,2.34,0.08,6.36,28
CDM,RX-71883,"INJECTION, DECITABINE, 1 MG",11.27,5.635,1.07,187.7,32
CDM,RX-71961,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",118.025,59.01,3.54,1286.64,31
CDM,RX-71980,Varicella vaccine,310.44,155.22,58.56,648.72,32
CDM,RX-7208,SODIUM CHLORIDE 3% VIAL,17.71,8.85,4.43,11.69,16
CDM,RX-72101,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",122.59,61.295,4.98,604.48,31
CDM,RX-72429,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",3036.78,1518.39,570.27,4130.03,32
CDM,RX-72468,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",224.60000000000002,112.305,4.98,604.48,31
CDM,RX-72471,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",225.45499999999998,112.72999999999999,4.98,604.48,31
CDM,RX-72606,"INJECTION, LEVETIRACETAM, 10 MG",5.28,2.64,0.07,7.18,28
CDM,RX-72621,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",222.55,111.28,4.98,604.48,31
CDM,RX-72812,PEG3350 100 GRAM-SOD SULF 7.5 GRAM-NACL-KCL-ASCORBATE-C ORAL PWDR PACK,238.79,119.4,59.7,157.6,16
CDM,RX-72851,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",10.0,5.0,2.5,6.6,16
CDM,RX-73018,"INJECTION, MICAFUNGIN SODIUM, 1 MG",1.54,0.77,0.38,2.23,28
CDM,RX-7305,SUCRALFATE 1 GRAM TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-742,"INJECTION, CEFAZOLIN SODIUM, 500 MG",27.22,13.61,1.37,37.02,28
CDM,RX-7434,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.18,15.59,1.44,100.58,28
CDM,RX-7447,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.26,0.63,0.25,1.71,28
CDM,RX-750000,"INJECTION, ACYCLOVIR, 5 MG",2.43,1.21,0.2,3.3,28
CDM,RX-750002,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",35.54,17.77,1.44,48.33,28
CDM,RX-750005,"INJECTION, CEFTAZIDIME, PER 500 MG",34.87,17.43,2.43,47.42,28
CDM,RX-750080,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",1.45,0.73,0.05,1.98,28
CDM,RX-750123,PRECEDEX 200 MCG/50 ML BOTTLE,10.94,5.47,2.74,7.22,16
CDM,RX-750134,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",103.0,51.5,3.28,140.08,28
CDM,RX-750190,CEFTRIAXONE IN NACL 0.9% 40 MG/ML INJECTION (PEDS),28.8,14.4,7.2,19.01,16
CDM,RX-750404,VANCOMYCIN 5 MG/ML LOCK SOLUTION,33.0,16.5,8.25,21.78,16
CDM,RX-7513,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",125.945,62.975,6.5,295.12,28
CDM,RX-7593,LISINOPRIL 20 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-7616,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",6.34,3.17,0.02,13.6,28
CDM,RX-7673,"INJECTION, THIOTEPA, NOT OTHERWISE SPECIFIED, 1 MG",1421.2,710.6,14.62,1932.83,27
CDM,RX-7813,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",4.38,2.19,0.12,5.96,28
CDM,RX-7924,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",515.33,257.67,154.6,700.85,27
CDM,RX-793,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,303.0,151.5,75.75,199.98,16
CDM,RX-7978,"INJECTION, CEFTAZIDIME, PER 500 MG",28.985,14.495000000000001,2.43,54.39,28
CDM,RX-7979,SPIRONOLACTONE 100 MG TABLET,20.0,10.0,5.0,13.2,16
CDM,RX-8028,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",2.52,1.26,0.33,3.42,28
CDM,RX-8104,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",220.38,110.19,0.05,304.31,28
CDM,RX-8123,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",20.6,10.3,0.2,28.02,28
CDM,RX-8153,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",12.65,6.325,0.2,20.25,28
CDM,RX-823,LATANOPROST 0.005 % EYE DROPS,649.25,324.63,162.31,428.51,16
CDM,RX-824,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",99065.685,49532.845,19791.36,134728.9,31
CDM,RX-8312,SENEXON-S 50-8.6 MG TABLET,15.765,7.88,3.96,12.04,16
CDM,RX-8445,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",81.32,40.66,6.34,110.59,28
CDM,RX-8614,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.6550000000000002,1.3250000000000002,0.02,4.32,28
CDM,RX-8686,"INJECTION, SULFAMETHOXAZOLE 5 MG AND TRIMETHOPRIM 1 MG",2.28,1.14,0.07,3.1,28
CDM,RX-871,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",55.38,27.69,16.61,75.32,28
CDM,RX-8838,OLANZAPINE 5 MG TABLET,40.84,20.42,10.21,26.95,16
CDM,RX-8853,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",575.33,287.67,172.17,2572.76,32
CDM,RX-8960,METRONIDAZOLE 250 MG TABLET,10.0,5.0,2.5,6.6,16
CDM,RX-900003,"INJECTION, DACTINOMYCIN, 0.5 MG",1789.5,894.75,508.18,2433.72,31
CDM,RX-900007,"INJECTION, DAUNORUBICIN, 10 MG",307.33,153.67,23.52,417.97,32
CDM,RX-900008,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",19.25,9.62,3.97,43.44,28
CDM,RX-900010,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",318.0,159.0,96.25,1677.59,31
CDM,RX-900011,"INJECTION, FLUOROURACIL, 500 MG",35.82,17.91,3.2,173.81,28
CDM,RX-9001,SODIUM CHLORIDE 0.45% SOLN,300.015,150.01,25.18,313.57,16
CDM,RX-900109,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",108.63,54.315,1.09,199.85,28
CDM,RX-900131,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
CDM,RX-900132,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",6.07,3.04,0.2,8.26,28
CDM,RX-900141,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",112.89,56.445,0.59,638.55,28
CDM,RX-900143,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",20.56,10.28,1.09,53.54,28
CDM,RX-900146,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",233.95999999999998,116.97999999999999,53.49,1286.64,31
CDM,RX-900147,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",61.765,30.88,18.47,5897.78,31
CDM,RX-900148,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",221.755,110.875,39.96,1286.64,31
CDM,RX-900153,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",235.18,117.59,53.49,1286.64,31
CDM,RX-900154,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",222.44,111.22,31.97,1286.64,31
CDM,RX-900157,"INJECTION, BELIMUMAB, 10 MG",115.1,57.55,34.53,1677.59,31
CDM,RX-900158,"INJECTION, BELIMUMAB, 10 MG",137.51,68.75,41.25,1677.59,31
CDM,RX-900221,"INJECTION, FLUOROURACIL, 500 MG",12.02,6.01,3.2,16.34,28
CDM,RX-900246,"INJECTION, ETOPOSIDE, 10 MG",3.81,1.91,1.08,5.24,28
CDM,RX-900247,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",12.09,6.04,0.15,16.44,28
CDM,RX-900295,SODIUM CHLORIDE 0.45% SOLN,490.09,245.04,122.52,323.46,16
CDM,RX-900936,HDM DEXTROSE 5% IN WATER (D5W) IV FLUSH SYRINGE 20 ML RPKG,56.65,28.325,2.58,67.98,16
CDM,RX-900946,PENTAMIDINE 300 MG SOLUTION FOR INJECTION (FOR OP USE ONLY),281.29,140.64,70.32,185.65,16
CDM,RX-900951,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR (CUSTOM),24.495,12.25,5.89,16.79,16
CDM,RX-9055,ANTI-DIARRHEAL 2 MG CAPLET,1.03,0.52,0.26,0.68,16
CDM,RX-9271,"METHYLPREDNISOLONE ORAL, PER 4 MG",12.96,6.48,0.23,17.63,28
CDM,RX-9352,MIDODRINE 5 MG TABLET,5.96,2.98,1.49,3.93,16
CDM,RX-9436,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",334.67499999999995,167.33499999999998,61.41,5911.01,32
CDM,RX-9460,FLUORESCITE 10% VIAL,97.51,48.75,24.38,64.35,16
CDM,RX-9499,"RINGERS LACTATE INFUSION, UP TO 1000 CC",67.34,33.665,3.93,136.54,28
CDM,RX-950006,"Pneumococcal vaccine, 13-valent",528.0699999999999,264.03499999999997,65.1,1141.23,32
CDM,RX-950008,5% DEXTROSE/WATER (500 ML = 1 UNIT),21.63,10.82,2.89,170.68,28
CDM,RX-950009,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",1506.51,753.255,37.98,2885.16,28
CDM,RX-950043,"APREPITANT, ORAL, 5 MG",153.42,76.71,4.57,208.65,28
CDM,RX-950058,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.18,15.59,1.44,42.4,28
CDM,RX-950065,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.41,15.71,1.44,42.72,28
CDM,RX-950081,"INJECTION, LANREOTIDE, 1 MG",225.31,112.655,58.39,5897.78,31
CDM,RX-950083,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",237.16,118.58,53.49,1286.64,31
CDM,RX-950090,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",8.68,4.34,0.59,250.41,31
CDM,RX-950091,"INJECTION, HEMIN, 1 MG",79.47999999999999,39.74,22.98,4737.06,31
CDM,RX-950093,"INJECTION, PEMBROLIZUMAB, 1 MG",489.0,244.5,98.55,9401.8,31
CDM,RX-950095,"INJECTION, PEMBROLIZUMAB, 1 MG",56584.08,28292.04,98.55,76954.35,31
CDM,RX-9761,"INJECTION, PANTOPRAZOLE SODIUM, 40 MG",59.23,29.61,4.52,505.24,28
CDM,RX-9953,DEXTROSE 20%-WATER IV SOLN,103.0,51.5,25.75,67.98,16
CDM,SUP-100728,GW 0.035X220X3 SAFE T J,1014.13,507.07,253.53,669.33,16
CDM,SUP-100729,GW 0.032X145X3 SAFE T J,1014.13,507.07,253.53,669.33,16
CDM,SUP-100740,"CATHETER, BALLOON DILATATION, NON-VASCULAR",410.69,205.35,123.21,558.54,28
CDM,SUP-100793,CATH URETH OD28FR 2 EYES,6436.02,3218.01,1609.01,4247.77,16
CDM,SUP-100795,CATH DRN MALECOT OD12FR 4 WING,230.14,115.07,57.54,151.89,16
CDM,SUP-102202,TY PROC CHOLE FLEXTRAY,1496.42,748.21,374.11,987.64,16
CDM,SUP-102277,NOZZLE BONE CEM 90DEG SMARTSET,6114.42,3057.21,1528.61,4035.52,16
CDM,SUP-102888,SET CATH RADL ART L1.75IN 20GA,600.505,300.255,149.64,397.62,16
CDM,SUP-104100,CANN VES L2IN L2MM BLNT TIP,3979.8,1989.9,994.95,2626.67,16
CDM,SUP-104673,BLDE SHV OD5.5MM STR LILAC,228.36,114.18,57.09,150.72,16
CDM,SUP-104675,BUR SURG OD4.5MM 8000RPM STR,228.36,114.18,57.09,150.72,16
CDM,SUP-104676,BUR SURG OD5.5MM 10000RPM STR,228.36,114.18,57.09,150.72,16
CDM,SUP-104677,BLDE SHV OD4MM 10000 RPM STR,516.58,258.29,129.15,340.94,16
CDM,SUP-104953,BLDE SAW 9MM CTEDG THK.51MM,8019.9,4009.95,2004.98,5293.13,16
CDM,SUP-104956,BLDE SAW L12.6CM 5.5MM CTEDG,6009.9,3004.95,1502.48,3966.53,16
CDM,SUP-105137,GUIDE WIRE,766.04,383.02,229.81,1041.81,28
CDM,SUP-105283,PK PHACO OD.9MM VSN US FMS,225.0,112.5,56.25,148.5,16
CDM,SUP-105615,BUR SURG 3X3.8 PRECISION MICRO,1437.15,718.58,359.29,948.52,16
CDM,SUP-105806,JOINT DEVICE (IMPLANTABLE),897.98,448.99,269.39,1221.25,28
CDM,SUP-105808,JOINT DEVICE (IMPLANTABLE),897.98,448.99,269.39,1221.25,28
CDM,SUP-106001,CATH BLNDIL L120CM OD9FR LP,1900.15,950.08,475.04,1254.1,16
CDM,SUP-106451,MESH (IMPLANTABLE),857.47,428.73,257.24,1166.16,28
CDM,SUP-106549,"CATHETER, OCCLUSION",4161.43,2080.715,1225.73,5762.43,28
CDM,SUP-106553,"CATHETER, OCCLUSION",4.36,2.18,1.31,5.93,28
CDM,SUP-106563,CATH DLP MALL SS VEN 20FR,867.37,433.68,216.84,572.46,16
CDM,SUP-106584,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",1292.27,646.14,387.68,1757.49,28
CDM,SUP-106595,CATH URETH L150CM OD3-2.4FR,2308.28,1154.14,577.07,1523.47,16
CDM,SUP-106598,RETRV ENDO OD2MM L4,693.19,346.6,173.3,457.51,16
CDM,SUP-106600,CATH INTVENT L125CM OD5.2FR,1401.24,700.62,350.31,924.82,16
CDM,SUP-106601,CATH INTVENT L130CM OD4.3FR,1449.07,724.53,362.27,956.39,16
CDM,SUP-106602,CANN PERF VEN 2-S OVAL 32/40F,144.03,72.02,36.01,95.06,16
CDM,SUP-107209,GUIDE WIRE,10215.55,5107.77,3064.66,13893.15,28
CDM,SUP-107449,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",20.65,10.32,6.19,28.08,28
CDM,SUP-107491,CATH 9FX90X8 FREEZOR,47.52,23.76,11.88,31.36,16
CDM,SUP-107580,RELOAD STAPLE 3.5 MULTIFIRE,10725.15,5362.58,2681.29,7078.6,16
CDM,SUP-107585,RELOAD STAPLE 45 ENDO GIA,894.97,447.49,223.74,590.68,16
CDM,SUP-107628,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",796.36,398.18,238.91,1083.05,28
CDM,SUP-107629,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",843.33,421.66,253.0,1146.92,28
CDM,SUP-107785,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",225.0,112.5,67.5,306.0,28
CDM,SUP-107913,CATH CRAGG-MCNAMARA 4F 65X20,243.39,121.7,60.85,160.64,16
CDM,SUP-107915,CATH 4FX100X10 CRAGG MCNAMARA,143.84,71.92,35.96,94.93,16
CDM,SUP-107929,CATH 5FX135X40 CRAGG MCNAMARA,4824.0,2412.0,1206.0,3183.84,16
CDM,SUP-107970,GWIRE VASC L300CM OD.014IN STR,2857.01,1428.5,714.25,1885.62,16
CDM,SUP-108038,CATH 3.4-2.2FX90 QUICK CROSS,25.84,12.92,6.46,17.05,16
CDM,SUP-108160,"GRAFT, VASCULAR",367.18,183.59,110.15,499.36,28
CDM,SUP-108293,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",708.82,354.41,212.65,964.0,28
CDM,SUP-108294,GUIDE WIRE,619.15,309.58,185.75,842.04,28
CDM,SUP-108294,GW 0.014X300 ASAHI FIELDER,619.15,309.58,154.79,408.64,16
CDM,SUP-108449,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",1306.62,653.31,391.99,1777.0,28
CDM,SUP-108450,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",1686.65,843.33,506.0,2293.84,28
CDM,SUP-108780,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",884.535,442.27,263.63,1210.81,28
CDM,SUP-108781,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",913.78,456.89,274.13,1242.74,28
CDM,SUP-108782,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",1026.94,513.47,308.08,1396.64,28
CDM,SUP-108783,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",167.04,83.52,50.11,227.17,28
CDM,SUP-108827,CATH 8.5FX45 ULTRATHANE,232.0,116.0,58.0,153.12,16
CDM,SUP-108835,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1135.58,567.79,340.67,1544.39,28
CDM,SUP-108838,CATH TORC HNB5.0-38-125-PNSVTK,960.75,480.38,240.19,634.1,16
CDM,SUP-108852,CATH SLIP 5.0-38-100-P-NS-SIM2,712.88,356.44,178.22,470.5,16
CDM,SUP-108867,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",185.6,92.8,55.68,252.42,28
CDM,SUP-108872,CATH INTRO 7FX90 TUOHY BORST,494.98,247.49,123.75,326.69,16
CDM,SUP-108875,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",320.25,160.13,96.08,435.54,28
CDM,SUP-108882,CATH 17FX25 KAYE,823.94,411.97,205.99,543.8,16
CDM,SUP-108883,SET 14FX32 PEEL AWAY,823.94,411.97,205.99,543.8,16
CDM,SUP-108884,CATH 5FX70 POLLACK,823.94,411.97,205.99,543.8,16
CDM,SUP-108886,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",938.84,469.42,281.65,1276.82,28
CDM,SUP-108887,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",938.84,469.42,281.65,1276.82,28
CDM,SUP-108888,CATH 3FX70,685.68,342.84,171.42,452.55,16
CDM,SUP-108903,CATH 7FX30,1159.69,579.85,289.92,765.4,16
CDM,SUP-108916,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",39.965,19.985,12.0,54.4,28
CDM,SUP-108917,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",889.53,444.77,266.86,1209.76,28
CDM,SUP-108941,CATH 9FX23,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-109119,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2135.0,1067.5,640.5,2903.6,28
CDM,SUP-109119,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",165.37,82.68,49.61,224.9,28
CDM,SUP-109119,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",10892.71,5446.36,1198.2,14814.09,28
CDM,SUP-109120,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",101093.72,50546.86,11120.31,137487.46,28
CDM,SUP-109176,CATH 5X20X75 MUSTANG,11864.34,5932.17,2966.09,7830.46,16
CDM,SUP-109177,CATH 5X30X135 MUSTANG,13312.14,6656.07,3328.04,8786.01,16
CDM,SUP-109178,CATH 5X40X135 MUSTANG,15156.18,7578.09,3789.05,10003.08,16
CDM,SUP-109180,CATH 5X60X135 MUSTANG,11864.34,5932.17,2966.09,7830.46,16
CDM,SUP-109181,CATH 5X80X135 MUSTANG,13312.14,6656.07,3328.04,8786.01,16
CDM,SUP-109183,CATH 5X150X135 MUSTANG,11864.34,5932.17,2966.09,7830.46,16
CDM,SUP-109184,CATH 5X200X135 MUSTANG,13312.14,6656.07,3328.04,8786.01,16
CDM,SUP-109190,CATH 6X60X135 MUSTANG,11864.34,5932.17,2966.09,7830.46,16
CDM,SUP-109191,CATH 6X80X135 MUSTANG,13312.14,6656.07,3328.04,8786.01,16
CDM,SUP-109193,CATH 6X150X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109194,CATH 6X200X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109195,CATH 7X20X135 MUSTANG,15544.8,7772.4,3886.2,10259.57,16
CDM,SUP-109196,CATH 7X20X75 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109197,CATH 7X30X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109198,CATH 7X40X135 MUSTANG,13750.29,6875.15,3437.57,9075.19,16
CDM,SUP-109199,CATH 7X40X75 MUSTANG,15544.8,7772.4,3886.2,10259.57,16
CDM,SUP-109200,CATH 7X80X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109201,CATH 7X120X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109202,CATH 8X20X135 MUSTANG,13750.29,6875.15,3437.57,9075.19,16
CDM,SUP-109203,CATH 8X20X75 MUSTANG,15544.8,7772.4,3886.2,10259.57,16
CDM,SUP-109205,CATH 8X40X135 MUSTANG,12424.41,6212.21,3106.1,8200.11,16
CDM,SUP-109206,CATH 8X40X75 MUSTANG,1014.13,507.07,253.53,669.33,16
CDM,SUP-109237,CATH 4FX4X220X150 ARMADA,156.53,78.27,39.13,103.31,16
CDM,SUP-109299,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",958.97,479.49,287.69,1304.2,28
CDM,SUP-109300,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",1088.85,544.43,326.66,1480.84,28
CDM,SUP-109302,BLDE SAW K148 MINI SAGITTAL,139.57,69.79,34.89,92.12,16
CDM,SUP-109328,CATH 6FX100 LAUNCHER AL1SH,1306.62,653.31,326.66,862.37,16
CDM,SUP-109420,CATH LAUNCHER 8F EBU 4.5 SH,6436.02,3218.01,1609.01,4247.77,16
CDM,SUP-109439,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",2109.74,1054.87,632.92,2869.25,28
CDM,SUP-109440,CATH 18FX30 AMPLATZ ANCHOR,3566.75,1783.38,891.69,2354.06,16
CDM,SUP-109441,CATH 12FX30 AMPLATZ ANCHOR,2109.74,1054.87,527.44,1392.43,16
CDM,SUP-109444,GUIDE WIRE,53.31,26.66,15.99,72.5,28
CDM,SUP-109487,CATH 2.8FX3X15X90 GATEWAY,97.44,48.72,24.36,64.31,16
CDM,SUP-109550,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4703.4,2351.7,1411.02,6396.62,28
CDM,SUP-109575,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1046.15,523.08,313.85,1422.76,28
CDM,SUP-109577,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1046.15,523.08,313.85,1422.76,28
CDM,SUP-109581,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1046.15,523.08,313.85,1422.76,28
CDM,SUP-109649,BUR SURG 1.5X15 ANSPACH,4703.4,2351.7,1175.85,3104.24,16
CDM,SUP-109696,GUIDE WIRE,1152.9,576.45,345.87,1567.94,28
CDM,SUP-109698,CATH NAVISTAR THERMOCOOL F,1426.18,713.09,356.55,941.28,16
CDM,SUP-109701,GW 0.018X300 NITREX,1494.5,747.25,373.63,986.37,16
CDM,SUP-109704,NDL ASPIR 22G NA-201SX-4922A,794.22,397.11,198.56,524.19,16
CDM,SUP-109707,CATH DRAIN NAVARRE 6F 30CM,3552.27,1776.14,888.07,2344.5,16
CDM,SUP-109727,COIL EMB 9X30 CONCERTO,8011.15,4005.57,2002.79,4950.89,16
CDM,SUP-109966,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",98914.0,49457.0,10880.54,134523.04,28
CDM,SUP-110029,HNDL CATH LP RELIEVA,1078.18,539.09,269.55,711.6,16
CDM,SUP-110035,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",1078.18,539.09,323.45,1466.32,28
CDM,SUP-110042,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",2194.92,1097.46,658.48,22396.74,32
CDM,SUP-110087,CATH PTCA L142CM L10MM RX ST,298.9,149.45,74.73,197.27,16
CDM,SUP-110155,BLN VRTBRL SZ-3 KYPHON ONE,61.95,30.98,15.49,40.89,16
CDM,SUP-110529,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),75810.0,37905.0,8339.1,103101.6,28
CDM,SUP-110667,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),64.96,32.48,19.49,88.35,28
CDM,SUP-110668,BIT DRL L195MM OD4.5MM 3 FLUT,55.68,27.84,13.92,36.75,16
CDM,SUP-110751,JOINT DEVICE (IMPLANTABLE),12172.95,6086.48,1339.02,16555.21,28
CDM,SUP-110994,BURR 4X13 DIAMOND,764.33,382.17,191.08,504.46,16
CDM,SUP-111000,BUR SURG 5X55 MICRO,1942.85,971.43,485.71,1282.28,16
CDM,SUP-111003,BUR SURG 3.6X13 XPS,9417.25,4708.63,2354.31,6215.39,16
CDM,SUP-111004,KT SURG FULL BTE BONE RECESS,9417.25,4708.63,2354.31,6215.39,16
CDM,SUP-111012,CANNULA 20FX29 FEM FLEX II,12212.84,6106.42,3053.21,8060.47,16
CDM,SUP-111014,CANNULA 18FX29 FEM FLEX II,12212.84,6106.42,3053.21,8060.47,16
CDM,SUP-111016,CANN 22FX28 AORT STR T CONN,12212.84,6106.42,3053.21,8060.47,16
CDM,SUP-111017,CANN 20FX28 AORT STR T CONN,12212.84,6106.42,3053.21,8060.47,16
CDM,SUP-111019,CANN PERF L14IN OD28FR 1 PC,12212.84,6106.42,3053.21,8060.47,16
CDM,SUP-111024,CANN IMA 1MM TIP 31001,4723.5,2361.75,1180.88,3117.51,16
CDM,SUP-111028,CANN PERF L16IN OD29X29FR VEN,4723.5,2361.75,1180.88,3117.51,16
CDM,SUP-111030,CANN VEN RET MALLEABLE 28F,4723.5,2361.75,1180.88,3117.51,16
CDM,SUP-111031,CANN VEN RET MALLEABLE 30F,4723.5,2361.75,1180.88,3117.51,16
CDM,SUP-111037,ELECTRODE 7 CARDIOBLATE,4924.5,2462.25,1231.13,3250.17,16
CDM,SUP-111041,ADH SURG 5ML CART BIOGLU,5607.9,2803.95,1401.98,3701.21,16
CDM,SUP-111065,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1078.18,539.09,323.45,1466.32,28
CDM,SUP-111071,CATH CHOLGM L18IN OD5.5FR ST,1473.15,736.58,368.29,972.28,16
CDM,SUP-111153,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",952.74,476.37,285.82,1295.73,28
CDM,SUP-111296,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),218.77,109.39,65.63,297.53,28
CDM,SUP-111490,APPL CLP OD5MM MED TI DISP,129.92,64.96,32.48,85.75,16
CDM,SUP-111516,JOINT DEVICE (IMPLANTABLE),2633.1,1316.55,789.93,3581.02,28
CDM,SUP-111517,JOINT DEVICE (IMPLANTABLE),1413.37,706.69,424.01,1922.18,28
CDM,SUP-111518,JOINT DEVICE (IMPLANTABLE),1904.42,952.21,571.33,2590.01,28
CDM,SUP-111703,JOINT DEVICE (IMPLANTABLE),3618.0,1809.0,1085.4,4920.48,28
CDM,SUP-111704,JOINT DEVICE (IMPLANTABLE),427.0,213.5,128.1,580.72,28
CDM,SUP-111707,JOINT DEVICE (IMPLANTABLE),11010.9,5505.45,1211.2,14974.82,28
CDM,SUP-111708,JOINT DEVICE (IMPLANTABLE),11010.9,5505.45,1211.2,14974.82,28
CDM,SUP-111709,JOINT DEVICE (IMPLANTABLE),2412.0,1206.0,723.6,3280.32,28
CDM,SUP-111713,JOINT DEVICE (IMPLANTABLE),854.0,427.0,256.2,1161.44,28
CDM,SUP-111815,JOINT DEVICE (IMPLANTABLE),212.28,106.14,63.68,288.7,28
CDM,SUP-111820,JOINT DEVICE (IMPLANTABLE),356.29,178.15,106.89,484.55,28
CDM,SUP-111862,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-111871,JOINT DEVICE (IMPLANTABLE),4723.5,2361.75,1417.05,6423.96,28
CDM,SUP-111872,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-111874,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-111876,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-112081,"REPAIR DEVICE, URINARY, INCONTINENCE, WITH SLING GRAFT",5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-112083,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-112099,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",2814.0,1407.0,844.2,3827.04,28
CDM,SUP-112451,JOINT DEVICE (IMPLANTABLE),19431.0,9715.5,2137.41,26426.16,28
CDM,SUP-112452,JOINT DEVICE (IMPLANTABLE),19431.0,9715.5,2137.41,26426.16,28
CDM,SUP-112502,JOINT DEVICE (IMPLANTABLE),2315.52,1157.76,694.66,3149.11,28
CDM,SUP-112503,JOINT DEVICE (IMPLANTABLE),2075.0,1037.5,622.5,2822.0,28
CDM,SUP-112525,JOINT DEVICE (IMPLANTABLE),1046.15,523.08,313.85,1422.76,28
CDM,SUP-112596,BUR SURG OD3MM RND FLUT AGG ST,1051.49,525.74,262.87,693.98,16
CDM,SUP-112614,BUR SURG OD4MM RND FLUT AGG ST,10050.0,5025.0,2512.5,6633.0,16
CDM,SUP-112615,BUR SURG 2.9X110 REX DMD CRVD,10050.0,5025.0,2512.5,6633.0,16
CDM,SUP-112673,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1271.05,635.53,381.32,1728.63,28
CDM,SUP-112719,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),9527.4,4763.7,1048.01,12957.26,28
CDM,SUP-112819,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-112820,JOINT DEVICE (IMPLANTABLE),5567.7,2783.85,1670.31,7572.07,28
CDM,SUP-112868,JOINT DEVICE (IMPLANTABLE),1387.75,693.88,416.33,1887.34,28
CDM,SUP-113040,JOINT DEVICE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-113042,GUIDE WIRE,768.6,384.3,230.58,1045.3,28
CDM,SUP-113047,JOINT DEVICE (IMPLANTABLE),785.68,392.84,235.7,1068.52,28
CDM,SUP-113050,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",768.6,384.3,230.58,1045.3,28
CDM,SUP-113069,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-113070,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",768.6,384.3,230.58,1045.3,28
CDM,SUP-113073,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",768.6,384.3,230.58,1045.3,28
CDM,SUP-113080,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-113082,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-113156,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1708.0,854.0,512.4,2322.88,28
CDM,SUP-113172,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6432.0,3216.0,1929.6,8747.52,28
CDM,SUP-113191,"GRAFT, VASCULAR",6432.0,3216.0,1929.6,8747.52,28
CDM,SUP-113200,JOINT DEVICE (IMPLANTABLE),10668.0,5334.0,1173.48,14508.48,28
CDM,SUP-113327,"IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL",3417.0,1708.5,1019.3,2255.22,28
CDM,SUP-113347,GUIDE WIRE,1750.1,875.05,525.03,2380.14,28
CDM,SUP-113357,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",2713.5,1356.75,814.05,3690.36,28
CDM,SUP-113365,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",4116.48,2058.24,1234.94,5598.41,28
CDM,SUP-113368,MESH (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-113381,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-113382,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-113637,CATH 3.5X12 SPRINTER,9906.0,4953.0,2476.5,6537.96,16
CDM,SUP-114241,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",9246.0,4623.0,1017.06,12574.56,28
CDM,SUP-114245,BUR SURG L7CM OD1MM BALL FLUT,2032.52,1016.26,508.13,1341.46,16
CDM,SUP-114246,BUR SURG L7CM OD2MM BALL FLUT,2032.52,1016.26,508.13,1341.46,16
CDM,SUP-114247,BUR SURG L7CM OD2MM SM BOR,2032.52,1016.26,508.13,1341.46,16
CDM,SUP-114248,BUR SURG L7CM OD3MM BALL FLUT,2032.52,1016.26,508.13,1341.46,16
CDM,SUP-114266,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",337.33,168.67,101.2,458.77,28
CDM,SUP-114267,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",337.33,168.67,101.2,458.77,28
CDM,SUP-114268,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",337.33,168.67,101.2,458.77,28
CDM,SUP-114270,"CATHETER, DRAINAGE",337.33,168.67,101.2,458.77,28
CDM,SUP-114271,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",337.33,168.67,101.2,458.77,28
CDM,SUP-114272,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",337.33,168.67,101.2,458.77,28
CDM,SUP-114295,KT PHACO 45DEG TBNG INFUS SL,4565.715,2282.8599999999997,1134.65,3031.28,16
CDM,SUP-114334,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),37.12,18.56,11.14,50.48,28
CDM,SUP-114566,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1648.22,824.11,494.47,2241.58,28
CDM,SUP-114577,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114578,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114585,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114586,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114597,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114598,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114603,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),14116.05,7058.03,1552.77,19197.83,28
CDM,SUP-114748,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2797.92,1398.96,839.38,3805.17,28
CDM,SUP-114769,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1046.15,523.08,313.85,1422.76,28
CDM,SUP-114795,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1067.5,533.75,320.25,1451.8,28
CDM,SUP-114949,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1952.29,976.14,585.69,2655.11,28
CDM,SUP-114977,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),209.47,104.73,62.84,284.88,28
CDM,SUP-114994,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-114995,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-114999,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),768.6,384.3,230.58,1045.3,28
CDM,SUP-115025,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2958.72,1479.36,887.62,4023.86,28
CDM,SUP-115026,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2978.22,1489.11,893.47,4050.38,28
CDM,SUP-115141,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2472.3,1236.15,741.69,3362.33,28
CDM,SUP-115183,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-115207,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),981.2,490.6,294.36,1334.43,28
CDM,SUP-115223,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1259.65,629.83,377.9,1713.12,28
CDM,SUP-115224,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),747.25,373.63,224.18,1016.26,28
CDM,SUP-115228,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),256.2,128.1,76.86,348.43,28
CDM,SUP-115229,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),256.2,128.1,76.86,348.43,28
CDM,SUP-115240,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1067.5,533.75,320.25,1451.8,28
CDM,SUP-115242,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),427.0,213.5,128.1,580.72,28
CDM,SUP-115243,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),427.0,213.5,128.1,580.72,28
CDM,SUP-115255,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),12954.0,6477.0,1424.94,17617.44,28
CDM,SUP-115256,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),12954.0,6477.0,1424.94,17617.44,28
CDM,SUP-115276,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1.52,0.76,0.46,2.07,28
CDM,SUP-115277,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),88.96,44.48,26.69,120.99,28
CDM,SUP-115377,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),9406.8,4703.4,1034.75,12793.25,28
CDM,SUP-115379,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),9406.8,4703.4,1034.75,12793.25,28
CDM,SUP-115604,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",5293.0,2646.5,1587.9,7198.48,28
CDM,SUP-115605,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",5477.25,2738.63,1643.18,7449.06,28
CDM,SUP-115606,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",4924.5,2462.25,1477.35,6697.32,28
CDM,SUP-115617,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1174.25,587.13,352.28,1596.98,28
CDM,SUP-115621,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3167.76,1583.88,950.33,4308.15,28
CDM,SUP-115635,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1179.59,589.79,353.88,1604.24,28
CDM,SUP-115641,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),811.3,405.65,243.39,1103.37,28
CDM,SUP-115643,KT SPNL MOD MAXCESS ST DISP,168.59,84.295,42.15,111.27,16
CDM,SUP-115645,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),220.4,110.2,66.12,299.74,28
CDM,SUP-115679,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6301.35,3150.68,1890.41,8569.84,28
CDM,SUP-115986,BIT DRL L160MM OD4MM 2 FLUT NS,341.6,170.8,85.4,225.46,16
CDM,SUP-116151,BIT DRL L110MM OD2.5MM 3 FLUT,55.68,27.84,13.92,36.75,16
CDM,SUP-116188,BIT DRL L215MM OD3.2MM 3 FLUT,102283.39,51141.69,25570.85,67507.04,16
CDM,SUP-116191,BIT DRL L215X90MM OD4MM QC NS,1387.75,693.88,346.94,915.92,16
CDM,SUP-116198,ROD XTRNFX L60MM OD3MM CFBR,137.53,68.77,34.38,90.77,16
CDM,SUP-116200,CLMP XTRNFX OD1.25MM HLD,248.94,124.47,62.24,164.3,16
CDM,SUP-116208,CLMP XTRNFX MED SELFHLD NS,605.27,302.64,151.32,399.48,16
CDM,SUP-116316,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-116317,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-116322,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1037.18,518.59,311.15,1410.57,28
CDM,SUP-116327,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1426.48,713.24,427.94,1940.01,28
CDM,SUP-116331,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1878.04,939.02,563.41,2554.13,28
CDM,SUP-116332,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),144.96,72.48,43.49,197.15,28
CDM,SUP-116394,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),23.2,11.6,6.96,31.55,28
CDM,SUP-116399,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),65792.25,32896.13,7237.15,89477.46,28
CDM,SUP-116400,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),7839.0,3919.5,2351.7,10661.04,28
CDM,SUP-116416,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),512.4,256.2,153.72,696.86,28
CDM,SUP-116900,"GRAFT, VASCULAR",64.59,32.3,19.38,87.84,28
CDM,SUP-116929,"GRAFT, VASCULAR",231.03,115.52,69.31,314.2,28
CDM,SUP-116931,"GRAFT, VASCULAR",136.88,68.44,41.06,186.16,28
CDM,SUP-116938,"GRAFT, VASCULAR",757.13,378.57,227.14,1029.7,28
CDM,SUP-116943,"GRAFT, VASCULAR",97.44,48.72,29.23,132.52,28
CDM,SUP-116961,"GRAFT, VASCULAR",512.4,256.2,153.72,696.86,28
CDM,SUP-116968,"GRAFT, VASCULAR",1281.0,640.5,384.3,1742.16,28
CDM,SUP-116978,"GRAFT, VASCULAR",220.91,110.46,66.27,300.44,28
CDM,SUP-116983,"GRAFT, VASCULAR",382.51,191.26,114.75,520.21,28
CDM,SUP-116988,"GRAFT, VASCULAR",187.8,93.9,56.34,255.41,28
CDM,SUP-117074,"GRAFT, VASCULAR",2011.38,1005.69,603.41,2735.48,28
CDM,SUP-117084,"GRAFT, VASCULAR",2011.38,1005.69,603.41,2735.48,28
CDM,SUP-117111,"GRAFT, VASCULAR",841.7,420.85,252.51,1144.71,28
CDM,SUP-117156,DEV INFL C20ML 26ATM SYR INLN,98.97,49.49,24.74,65.32,16
CDM,SUP-117202,JOINT DEVICE (IMPLANTABLE),5291.61,2645.81,1587.48,7196.59,28
CDM,SUP-117228,JOINT DEVICE (IMPLANTABLE),226.03,113.02,67.81,307.4,28
CDM,SUP-117238,JOINT DEVICE (IMPLANTABLE),4783.8,2391.9,1435.14,6505.97,28
CDM,SUP-117257,JOINT DEVICE (IMPLANTABLE),37.12,18.56,11.14,50.48,28
CDM,SUP-117260,JOINT DEVICE (IMPLANTABLE),823.94,411.97,247.18,1120.56,28
CDM,SUP-117261,JOINT DEVICE (IMPLANTABLE),938.84,469.42,281.65,1276.82,28
CDM,SUP-117262,JOINT DEVICE (IMPLANTABLE),1159.69,579.85,347.91,1577.18,28
CDM,SUP-117273,JOINT DEVICE (IMPLANTABLE),441.95,220.98,132.59,601.05,28
CDM,SUP-117278,JOINT DEVICE (IMPLANTABLE),414.79,207.4,124.44,564.11,28
CDM,SUP-117280,JOINT DEVICE (IMPLANTABLE),412.06,206.03,123.62,560.4,28
CDM,SUP-117293,JOINT DEVICE (IMPLANTABLE),247.13,123.56,74.14,336.09,28
CDM,SUP-117298,JOINT DEVICE (IMPLANTABLE),5145.6,2572.8,1543.68,6998.02,28
CDM,SUP-117307,JOINT DEVICE (IMPLANTABLE),448.35,224.18,134.51,609.76,28
CDM,SUP-117309,JOINT DEVICE (IMPLANTABLE),512.4,256.2,153.72,696.86,28
CDM,SUP-117310,JOINT DEVICE (IMPLANTABLE),574.32,287.16,172.3,781.08,28
CDM,SUP-117314,JOINT DEVICE (IMPLANTABLE),25690.83,12845.42,2825.99,34939.53,28
CDM,SUP-117315,JOINT DEVICE (IMPLANTABLE),25690.83,12845.42,2825.99,34939.53,28
CDM,SUP-117316,JOINT DEVICE (IMPLANTABLE),25690.83,12845.42,2825.99,34939.53,28
CDM,SUP-117331,JOINT DEVICE (IMPLANTABLE),2525.73,1262.87,757.72,3434.99,28
CDM,SUP-117367,JOINT DEVICE (IMPLANTABLE),320.25,160.13,96.08,435.54,28
CDM,SUP-117596,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",2525.73,1262.87,757.72,3434.99,28
CDM,SUP-117630,JOINT DEVICE (IMPLANTABLE),711.67,355.84,213.5,967.87,28
CDM,SUP-117649,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),117325.0,58662.5,12905.75,159562.0,28
CDM,SUP-117675,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6114.42,3057.21,1834.33,8315.61,28
CDM,SUP-117683,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1914.26,957.13,574.28,2603.4,28
CDM,SUP-117694,BIT DRL L100MM OD1.1MM SS NS,248.94,124.47,62.24,164.3,16
CDM,SUP-117701,BLDE SAW L30CM GIGLI DISP,1302.35,651.175,277.55,911.65,16
CDM,SUP-117706,JOINT DEVICE (IMPLANTABLE),5477.25,2738.63,1643.18,7449.06,28
CDM,SUP-117707,JOINT DEVICE (IMPLANTABLE),2412.0,1206.0,723.6,3280.32,28
CDM,SUP-117714,JOINT DEVICE (IMPLANTABLE),3911.46,1955.73,1173.44,5319.59,28
CDM,SUP-117719,JOINT DEVICE (IMPLANTABLE),72200.0,36100.0,7942.0,98192.0,28
CDM,SUP-117865,JOINT DEVICE (IMPLANTABLE),362.95,181.48,108.89,493.61,28
CDM,SUP-117867,JOINT DEVICE (IMPLANTABLE),384.3,192.15,115.29,522.65,28
CDM,SUP-117940,JOINT DEVICE (IMPLANTABLE),19013.69,9506.85,2091.51,25858.62,28
CDM,SUP-117941,JOINT DEVICE (IMPLANTABLE),19518.06,9759.03,2146.99,26544.56,28
CDM,SUP-118042,JOINT DEVICE (IMPLANTABLE),7577.7,3788.85,2273.31,10305.67,28
CDM,SUP-118070,JOINT DEVICE (IMPLANTABLE),1037.18,518.59,311.15,1410.56,28
CDM,SUP-118189,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",832.39,416.2,249.72,1132.05,28
CDM,SUP-118207,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),691.14,345.57,207.34,939.95,28
CDM,SUP-118210,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),691.14,345.57,207.34,939.95,28
CDM,SUP-118211,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),455.14,227.57,136.54,618.99,28
CDM,SUP-118435,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),182.72,91.36,54.82,248.5,28
CDM,SUP-118438,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),92.99,46.5,27.9,126.47,28
CDM,SUP-118440,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),116.42,58.21,34.93,158.33,28
CDM,SUP-118441,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),123.02,61.51,36.91,167.31,28
CDM,SUP-118442,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),124.68,62.34,37.4,169.56,28
CDM,SUP-118445,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),124.68,62.34,37.4,169.56,28
CDM,SUP-118446,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),218.33,109.17,65.5,296.93,28
CDM,SUP-118508,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),640.5,320.25,192.15,871.08,28
CDM,SUP-118583,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),682.13,341.07,204.64,927.7,28
CDM,SUP-118584,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),682.13,341.07,204.64,927.7,28
CDM,SUP-118638,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-118640,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3532.58,1766.29,1059.77,4804.3,28
CDM,SUP-118642,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3417.0,1708.5,1025.1,4647.12,28
CDM,SUP-118648,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-118650,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-118652,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-118653,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-118664,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1358.97,679.49,407.69,1848.2,28
CDM,SUP-118842,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4824.0,2412.0,1447.2,6560.64,28
CDM,SUP-118843,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4824.0,2412.0,1447.2,6560.64,28
CDM,SUP-118844,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4824.0,2412.0,1447.2,6560.64,28
CDM,SUP-118845,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4824.0,2412.0,1447.2,6560.64,28
CDM,SUP-118848,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2304.56,1152.28,691.37,3134.2,28
CDM,SUP-119759,JOINT DEVICE (IMPLANTABLE),2412.0,1206.0,723.6,3280.32,28
CDM,SUP-119760,JOINT DEVICE (IMPLANTABLE),3417.0,1708.5,1025.1,4647.12,28
CDM,SUP-120863,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1526.53,763.27,457.96,2076.08,28
CDM,SUP-121192,JOINT DEVICE (IMPLANTABLE),1945.24,972.62,583.57,2645.53,28
CDM,SUP-121209,JOINT DEVICE (IMPLANTABLE),220.85,110.43,66.26,300.36,28
CDM,SUP-121487,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",2158.74,1079.37,647.62,2935.89,28
CDM,SUP-122497,JOINT DEVICE (IMPLANTABLE),83.04,41.52,24.91,112.93,28
CDM,SUP-122585,JOINT DEVICE (IMPLANTABLE),12058.65,6029.33,1326.45,16399.76,28
CDM,SUP-122588,JOINT DEVICE (IMPLANTABLE),13357.86,6678.93,1469.36,18166.69,28
CDM,SUP-122626,JOINT DEVICE (IMPLANTABLE),1025.48,512.74,307.64,1394.65,28
CDM,SUP-122630,JOINT DEVICE (IMPLANTABLE),1025.48,512.74,307.64,1394.65,28
CDM,SUP-122896,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",5025.0,2512.5,1507.5,6834.0,28
CDM,SUP-122897,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5025.0,2512.5,1507.5,6834.0,28
CDM,SUP-122898,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",5025.0,2512.5,1507.5,6834.0,28
CDM,SUP-122901,NDL ELECSURG L178MM 45DEG ANG,20269.2,10134.6,5067.3,13377.67,16
CDM,SUP-123087,JOINT DEVICE (IMPLANTABLE),4333.56,2166.78,1300.07,5893.64,28
CDM,SUP-123251,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",9648.0,4824.0,1061.28,13121.28,28
CDM,SUP-123270,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),32.43,16.22,9.73,44.11,28
CDM,SUP-123271,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),48.02,24.01,14.41,65.31,28
CDM,SUP-123413,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-123414,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-123415,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1611.93,805.96,483.58,2192.22,28
CDM,SUP-123598,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),806.65,403.32,241.99,1097.04,28
CDM,SUP-123759,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6199.12,3099.56,1859.74,8430.8,28
CDM,SUP-123760,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6983.79,3491.9,2095.14,9497.95,28
CDM,SUP-123761,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2163.64,1081.82,649.09,2942.55,28
CDM,SUP-123764,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1066.09,533.05,319.83,1449.88,28
CDM,SUP-123766,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),196.6,98.3,58.98,267.38,28
CDM,SUP-123798,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4703.4,2351.7,1411.02,6396.62,28
CDM,SUP-123799,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),5680.26,2840.13,1704.08,7725.15,28
CDM,SUP-123864,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),319.35,159.68,95.81,434.32,28
CDM,SUP-123866,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),111.96,55.98,33.59,152.27,28
CDM,SUP-123870,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),294.97,147.49,88.49,401.16,28
CDM,SUP-123877,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),59565.0,29782.5,6552.15,81008.4,28
CDM,SUP-123881,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),123.38,61.69,37.01,167.79,28
CDM,SUP-123882,BIT DRL OD2MM QUIK CPLR,198.13,99.06,49.53,130.76,16
CDM,SUP-123885,GUIDE WIRE,337.12,168.56,101.13,458.48,28
CDM,SUP-123886,GUIDE WIRE,321.57,160.79,96.47,437.34,28
CDM,SUP-123887,GUIDE WIRE,337.12,168.56,101.14,458.48,28
CDM,SUP-123888,GUIDE WIRE,1725.72,862.86,517.72,2346.98,28
CDM,SUP-123893,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),180.78,90.39,54.23,245.85,28
CDM,SUP-123920,JOINT DEVICE (IMPLANTABLE),153.12,76.56,45.94,208.24,28
CDM,SUP-123933,JOINT DEVICE (IMPLANTABLE),2506.74,1253.37,752.02,3409.16,28
CDM,SUP-123957,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",115.63,57.81,34.69,157.25,28
CDM,SUP-124031,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),15.87,7.94,4.76,21.58,28
CDM,SUP-124031,JOINT DEVICE (IMPLANTABLE),15.87,7.94,4.76,21.58,28
CDM,SUP-124397,"GRAFT, VASCULAR",201.79,100.9,60.54,274.43,28
CDM,SUP-124598,BOLT XTRNFX WIRE COMB,147.39,73.7,36.85,97.28,16
CDM,SUP-124600,CUBE XTRNFX 1 H POST,1603.16,801.58,400.79,1058.09,16
CDM,SUP-124601,ROD XTRNFX L100MM THRD ILIZ SS,643.72,321.86,160.93,424.85,16
CDM,SUP-124602,ROD XTRNFX L120MM THRD ILIZ SS,2231.56,1115.78,557.89,1472.83,16
CDM,SUP-124638,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),130359.63,65179.82,14339.56,177289.1,28
CDM,SUP-124712,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2113.65,1056.83,634.1,2874.56,28
CDM,SUP-124714,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),117.355,58.68,34.85,171.1,28
CDM,SUP-124715,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1174.25,587.13,352.28,1596.98,28
CDM,SUP-124761,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1376.82,688.41,413.05,1872.48,28
CDM,SUP-124822,OCULAR IMPLANT,125.86,62.93,37.76,1138.35,28
CDM,SUP-124824,GDPN ORTH L152MM OD2.4MM DISP,7798.8,3899.4,1949.7,5147.21,16
CDM,SUP-124877,JOINT DEVICE (IMPLANTABLE),319.57,159.79,95.87,434.62,28
CDM,SUP-125037,DEV ANAS OD18FR CLP SGL ARM SH,263.84,131.92,65.96,174.13,16
CDM,SUP-125043,DEV ANAS OD50MM TI CLP SH FLEX,275.37,137.69,68.84,181.74,16
CDM,SUP-125048,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1376.82,688.41,413.05,1872.48,28
CDM,SUP-125049,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1376.82,688.41,413.05,1872.48,28
CDM,SUP-125241,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",5407.86,2703.93,1622.36,7354.69,28
CDM,SUP-125436,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),418.04,209.02,125.41,568.53,28
CDM,SUP-125437,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),124.15,62.08,37.25,168.84,28
CDM,SUP-125499,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",68700.79,34350.39,7557.09,93433.07,28
CDM,SUP-125506,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4729.53,2364.77,1418.86,6432.16,28
CDM,SUP-125507,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",4729.53,2364.77,1418.86,6432.16,28
CDM,SUP-125627,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),7.72,3.86,2.32,10.5,28
CDM,SUP-125633,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),444.7,222.35,133.41,604.79,28
CDM,SUP-125731,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1750.7,875.35,525.21,2380.95,28
CDM,SUP-125732,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1836.1,918.05,550.83,2497.1,28
CDM,SUP-125733,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1921.5,960.75,576.45,2613.24,28
CDM,SUP-125734,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2113.65,1056.83,634.1,2874.56,28
CDM,SUP-125819,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),33.41,16.71,10.02,45.44,28
CDM,SUP-125828,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),10189.81,5094.9,1120.88,13858.14,28
CDM,SUP-125829,JOINT DEVICE (IMPLANTABLE),10175.05,5087.52,1119.26,13838.06,28
CDM,SUP-125832,JOINT DEVICE (IMPLANTABLE),11430.0,5715.0,1257.3,15544.8,28
CDM,SUP-125833,JOINT DEVICE (IMPLANTABLE),12573.0,6286.5,1383.03,17099.28,28
CDM,SUP-126128,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),10531.02,5265.515,1167.19,14430.76,28
CDM,SUP-126221,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),39.9,19.95,11.97,54.27,28
CDM,SUP-126234,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1708.0,854.0,512.4,2322.88,28
CDM,SUP-126240,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1622.6,811.3,486.78,2206.74,28
CDM,SUP-126241,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1622.6,811.3,486.78,2206.74,28
CDM,SUP-126245,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3083.01,1541.5,924.9,4192.89,28
CDM,SUP-126246,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-126247,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3049.34,1524.67,914.8,4147.1,28
CDM,SUP-126248,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-126249,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-126250,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-126251,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-126252,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3023.04,1511.52,906.91,4111.33,28
CDM,SUP-126253,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3050.33,1525.16,915.1,4148.45,28
CDM,SUP-126254,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3055.2,1527.6,916.56,4155.07,28
CDM,SUP-126267,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),116.0,58.0,34.8,157.76,28
CDM,SUP-126288,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),556.95,278.48,167.09,757.46,28
CDM,SUP-126289,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),514.11,257.06,154.23,699.19,28
CDM,SUP-126303,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126304,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126305,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),92.8,46.4,27.84,126.21,28
CDM,SUP-126306,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),92.8,46.4,27.84,126.21,28
CDM,SUP-126307,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126308,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126309,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126310,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126311,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126312,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126313,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-126328,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-126331,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126333,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-126334,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-126335,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126336,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2713.5,1356.75,814.05,3690.36,28
CDM,SUP-126343,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126344,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126345,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126348,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),486.78,243.39,146.03,662.02,28
CDM,SUP-126547,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),1708.0,854.0,512.4,2322.88,28
CDM,SUP-126555,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),1622.6,811.3,486.78,2206.74,28
CDM,SUP-126556,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),7256.1,3628.05,2176.83,9868.3,28
CDM,SUP-126557,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),11430.0,5715.0,1257.3,15544.8,28
CDM,SUP-126586,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),769.88,384.94,230.96,1047.04,28
CDM,SUP-126587,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2135.0,1067.5,640.5,2903.6,28
CDM,SUP-126625,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),9627.9,4813.95,1059.07,13093.94,28
CDM,SUP-126628,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4020.0,2010.0,1206.0,5467.2,28
CDM,SUP-126702,CATH 12FX12X0.038,2512.5,1256.25,628.13,1658.25,16
CDM,SUP-126731,JOINT DEVICE (IMPLANTABLE),10477.5,5238.75,1152.53,14249.4,28
CDM,SUP-126795,JOINT DEVICE (IMPLANTABLE),2088.93,1044.4650000000001,626.68,2840.94,28
CDM,SUP-126822,JOINT DEVICE (IMPLANTABLE),50.48,25.24,15.14,68.65,28
CDM,SUP-126865,JOINT DEVICE (IMPLANTABLE),2158.74,1079.37,647.62,2935.89,28
CDM,SUP-126920,JOINT DEVICE (IMPLANTABLE),290.36,145.18,87.11,394.89,28
CDM,SUP-127133,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",3015.0,1507.5,904.5,4100.4,28
CDM,SUP-127236,APPLIER 10 ENDO CLIP,28956.0,14478.0,7239.0,19110.96,16
CDM,SUP-127237,"IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL",28956.0,14478.0,1019.3,17894.81,28
CDM,SUP-127480,BIT DRL OD2MM CLAW 2,2291.4,1145.7,572.85,1512.32,16
CDM,SUP-127481,ELECTRODE 3FX105 BUGBEE,2291.4,1145.7,572.85,1512.32,16
CDM,SUP-127482,DRL SURG TRGN INTERTAN,2291.4,1145.7,572.85,1512.32,16
CDM,SUP-127510,JOINT DEVICE (IMPLANTABLE),25069.8,12534.9,2757.68,34094.93,28
CDM,SUP-127521,JOINT DEVICE (IMPLANTABLE),25069.8,12534.9,2757.68,34094.93,28
CDM,SUP-127522,JOINT DEVICE (IMPLANTABLE),25069.8,12534.9,2757.68,34094.93,28
CDM,SUP-127531,JOINT DEVICE (IMPLANTABLE),284.53,142.27,85.36,386.96,28
CDM,SUP-127532,JOINT DEVICE (IMPLANTABLE),1004.79,502.4,301.44,1366.52,28
CDM,SUP-127533,JOINT DEVICE (IMPLANTABLE),1838.75,919.38,551.63,2500.7,28
CDM,SUP-127538,JOINT DEVICE (IMPLANTABLE),2229.83,1114.91,668.95,3032.56,28
CDM,SUP-127539,JOINT DEVICE (IMPLANTABLE),1648.84,824.42,494.65,2242.42,28
CDM,SUP-127540,JOINT DEVICE (IMPLANTABLE),2444.35,1222.17,733.3,3324.31,28
CDM,SUP-127541,JOINT DEVICE (IMPLANTABLE),5508.04,2754.02,1652.41,7490.93,28
CDM,SUP-127542,JOINT DEVICE (IMPLANTABLE),5191.71,2595.86,1557.51,7060.73,28
CDM,SUP-130116,RETRV STNT SOEHENDRA G21937,2211.0,1105.5,552.75,1459.26,16
CDM,SUP-130118,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2211.0,1105.5,663.3,3006.96,28
CDM,SUP-130119,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2211.0,1105.5,663.3,3006.96,28
CDM,SUP-130149,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3055.2,1527.6,916.56,4155.07,28
CDM,SUP-130161,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-130163,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-130164,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-130166,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3015.0,1507.5,904.5,4100.4,28
CDM,SUP-130335,JOINT DEVICE (IMPLANTABLE),13750.29,6875.15,1512.53,18700.39,28
CDM,SUP-130336,JOINT DEVICE (IMPLANTABLE),13750.29,6875.15,1512.53,18700.39,28
CDM,SUP-130337,JOINT DEVICE (IMPLANTABLE),13750.29,6875.15,1512.53,18700.39,28
CDM,SUP-130338,JOINT DEVICE (IMPLANTABLE),13750.29,6875.15,1512.53,18700.39,28
CDM,SUP-130339,JOINT DEVICE (IMPLANTABLE),15544.8,7772.4,1709.93,21140.93,28
CDM,SUP-132061,SCOPE SEAL MYOSURE,640.5,320.25,160.13,422.73,16
CDM,SUP-132213,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1479.25,739.63,443.78,2011.79,28
CDM,SUP-132458,ELECTRD ELECSURG L6IN L3/4IN,4321.5,2160.75,1080.38,2852.19,16
CDM,SUP-132942,CLIP 6.2X8 YAS S T,232.0,116.0,58.0,153.12,16
CDM,SUP-132943,CLP ANRSM 3X3.3 YAS MINI M T,744.42,372.21,186.1,491.32,16
CDM,SUP-132944,CLIP 4X4X5 YAS M T,14.870000000000001,7.4350000000000005,3.73,9.84,16
CDM,SUP-132945,CLIP 4.4X6.6 YAS M T,228.79,114.39,57.2,151.0,16
CDM,SUP-133057,SZR BRST 450-480CC NATRELLE MP,960.75,480.38,240.19,634.1,16
CDM,SUP-133080,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",3886.9,1943.45,1166.07,5286.18,28
CDM,SUP-133080,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",3886.9,1943.45,1166.07,5286.18,28
CDM,SUP-133228,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",226.31,113.16,67.89,307.78,28
CDM,SUP-133473,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",366.37,183.18,109.91,498.26,28
CDM,SUP-133663,TATTOO PIG FLESH 9 PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133664,TATTOO PIG FLESH 10 PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133665,TATTOO PIG BLACK PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133668,TATTOO PIG BLONDE K21 PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133669,TATTOO PIG KAJAL PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133670,TATTOO PIG DESERT ROSE PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133671,TATTOO PIG DARK CHOC PERMARK,5628.0,2814.0,1407.0,3714.48,16
CDM,SUP-133686,BOTTLE 1000CC PLEURX,2613.0,1306.5,653.25,1724.58,16
CDM,SUP-133687,KIT 15.5F PLEURX,2613.0,1306.5,653.25,1724.58,16
CDM,SUP-133725,NDL 13X12 PRECISION,7437.0,3718.5,1859.25,4908.42,16
CDM,SUP-133755,GUIDE WIRE,2814.0,1407.0,844.2,3827.04,28
CDM,SUP-133758,CATH 6FX100 LAUNCHER HS2,2814.0,1407.0,703.5,1857.24,16
CDM,SUP-133798,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",2158.74,1079.37,647.62,2935.89,28
CDM,SUP-141129,KT ELECSURG L100MM OD17GA L4MM,13716.0,6858.0,3429.0,9052.56,16
CDM,SUP-141139,KT ELECSURG L75MM OD17GA L4MM,14478.0,7239.0,3619.5,9555.48,16
CDM,SUP-141207,PK SURG PLANTAR ENDOS HOOK,148.3,74.15,37.08,97.88,16
CDM,SUP-141209,"KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, OFF-THE SHELF",12858.75,6429.38,509.63,7946.71,28
CDM,SUP-141302,BLDE SHV L13CM OD5MM CUT ST,2572.28,1286.14,643.07,1697.7,16
CDM,SUP-141598,JOINT DEVICE (IMPLANTABLE),218.77,109.39,65.63,297.53,28
CDM,SUP-141599,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141600,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141603,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141606,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141607,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141608,JOINT DEVICE (IMPLANTABLE),4321.5,2160.75,1296.45,5877.24,28
CDM,SUP-141622,JOINT DEVICE (IMPLANTABLE),9889.2,4944.6,1087.81,13449.31,28
CDM,SUP-141631,JOINT DEVICE (IMPLANTABLE),56316.0,28158.0,6194.76,76589.76,28
CDM,SUP-142734,POSTERIOR CHAMBER INTRAOCULAR LENS,1904.42,952.21,145.73,1256.92,28
CDM,SUP-142817,POSTERIOR CHAMBER INTRAOCULAR LENS,52886.5,26443.25,145.73,32683.86,28
CDM,SUP-142819,POSTERIOR CHAMBER INTRAOCULAR LENS,50540.0,25270.0,145.73,31233.72,28
CDM,SUP-143308,POSTERIOR CHAMBER INTRAOCULAR LENS,384.93,192.47,115.48,254.05,28
CDM,SUP-143310,POSTERIOR CHAMBER INTRAOCULAR LENS,277.55,138.78,83.27,198.19,28
CDM,SUP-143424,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,5330.52,2665.26,1599.16,7249.51,28
CDM,SUP-143425,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,5330.52,2665.26,1599.16,7249.51,28
CDM,SUP-143426,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,5330.52,2665.26,1599.16,7249.51,28
CDM,SUP-143427,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,5330.52,2665.26,1599.16,7249.51,28
CDM,SUP-143428,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,5330.52,2665.26,1599.16,7249.51,28
CDM,SUP-143430,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,9789.71,4894.85,1076.87,13314.0,28
CDM,SUP-145220,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),747.25,373.63,224.18,1016.26,28
CDM,SUP-145277,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),10287.0,5143.5,1131.57,13990.32,28
CDM,SUP-145284,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),60.13,30.07,18.04,81.78,28
CDM,SUP-145287,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),16363.95,8181.98,1800.03,22254.97,28
CDM,SUP-145288,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),11380.47,5690.24,1251.85,15477.44,28
CDM,SUP-145300,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),10668.0,5334.0,1173.48,14508.48,28
CDM,SUP-145301,JOINT DEVICE (IMPLANTABLE),2211.0,1105.5,663.3,3006.96,28
CDM,SUP-145607,JOINT DEVICE (IMPLANTABLE),2066.68,1033.34,620.0,2810.68,28
CDM,SUP-145612,JOINT DEVICE (IMPLANTABLE),1385.62,692.81,415.69,1884.44,28
CDM,SUP-145629,JOINT DEVICE (IMPLANTABLE),17011.65,8505.83,1871.28,23135.84,28
CDM,SUP-145891,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",247.06,123.53,74.12,336.0,28
CDM,SUP-147668,KT POLY PICC COMPLETE 1.4,5591.42,2795.71,1677.43,3354.85,2
CDM,SUP-148125,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",389587.59,194793.8,116876.28,529839.12,28
CDM,SUP-148126,CATH 4FX120 GLIDECATH CRV ANG,22631.4,11315.7,5657.85,14936.72,16
CDM,SUP-150034,BLLN NANOX 3.0 X 40 X 150,3979.8,1989.9,994.95,2626.67,16
CDM,SUP-150035,BLLN NANOX 3.0 X 100 X 150,3979.8,1989.9,994.95,2626.67,16
CDM,SUP-150036,BLLN NANOX 3 X 150 X 150,5185.8,2592.9,1296.45,3422.63,16
CDM,SUP-160046,KT PROBE COOL RF 100,11811.0,5905.5,2952.75,7795.26,16
CDM,SUP-160047,KNIFE CARPEL TUNNEL  15DEG,11811.0,5905.5,2952.75,7795.26,16
CDM,SUP-160234,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",823.14,411.57,246.94,1119.46,28
CDM,SUP-160235,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",838.09,419.05,251.43,1139.81,28
CDM,SUP-160236,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",842.66,421.33,252.8,1146.01,28
CDM,SUP-160238,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1099.25,549.63,329.78,1494.98,28
CDM,SUP-160239,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",110.995,55.5,33.42,151.51,28
CDM,SUP-160240,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1765.3,882.65,529.59,2400.81,28
CDM,SUP-160241,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1765.3,882.65,529.59,2400.81,28
CDM,SUP-160243,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1434.72,717.36,430.42,1951.22,28
CDM,SUP-160491,JOINT DEVICE (IMPLANTABLE),1174.25,587.13,352.28,1596.98,28
CDM,SUP-160492,JOINT DEVICE (IMPLANTABLE),1174.25,587.13,352.28,1596.98,28
CDM,SUP-161100,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",950.5,475.25,285.15,1292.68,28
CDM,SUP-161103,CATHETER 160CM,807.03,403.52,201.76,532.64,16
CDM,SUP-161253,ROLL TOWL ENMOTION NTRL 800INC,725.0,362.5,217.5,435.0,2
CDM,SUP-161254,CORELESS BATH TISSUE COMPACT 2,725.0,362.5,217.5,435.0,2
CDM,SUP-161256,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",3195.1,1597.55,958.53,4345.34,28
CDM,SUP-161270,INTRO 8FX4 PRELUDE,362.95,181.48,90.74,239.55,16
CDM,SUP-161271,CATH 8FX4X115 FLEXIBILITY NON,3650.56,1825.28,912.64,2409.37,16
CDM,SUP-161275,CABLE ADVISOR SENSOR ENABLED,2052.25,1026.12,513.06,1354.48,16
CDM,SUP-163254,CATH 12X2X3.5F COEFFICIENT,5226.0,2613.0,1306.5,3449.16,16
CDM,SUP-163263,CATH 6FX100 VISTA BRITE TIP,2814.0,1407.0,703.5,1857.24,16
CDM,SUP-163266,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",2412.0,1206.0,723.6,3280.32,28
CDM,SUP-163267,CATH 6FX0.071X90 LAUNCHER MP1,2412.0,1206.0,603.0,1591.92,16
CDM,SUP-163358,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",69961.8,34980.9,7695.8,95148.05,28
CDM,SUP-163538,CANNULA PRFSN 24FR AOR CRV TIP,4446.12,2223.06,1111.53,2934.44,16
CDM,SUP-163542,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4446.12,2223.06,1333.84,6046.72,28
CDM,SUP-163563,"PROSTHESIS, BREAST (IMPLANTABLE)",8040.0,4020.0,2412.0,10934.4,28
CDM,SUP-163565,"PROSTHESIS, BREAST (IMPLANTABLE)",8040.0,4020.0,2412.0,10934.4,28
CDM,SUP-163569,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",5226.0,2613.0,1567.8,7107.36,28
CDM,SUP-163661,BI DIR 7FR DEF CS F-J 12 PIN,3819.0,1909.5,954.75,2520.54,16
CDM,SUP-163672,OXMTR ONYX VNTGE FGRTP BLUE,3819.0,1909.5,1145.7,2291.4,2
CDM,SUP-163677,SYSTEM BN PRSPC ANLYZ,6930.48,3465.24,2079.14,4158.29,2
CDM,SUP-163682,NON STRL 100 DISPSBLE WHTE TWL,5628.0,2814.0,1688.4,3376.8,2
CDM,SUP-163985,ANTI FLO CYTO CD3 SP34-2,212.21,106.11,63.66,127.33,2
CDM,SUP-163997,KT FCL OCCLT BLD DEVICE MICRO,1031.88,515.94,309.56,619.13,2
CDM,SUP-164394,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4703.4,2351.7,1411.02,6396.62,28
CDM,SUP-164395,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4703.4,2351.7,1411.02,6396.62,28
CDM,SUP-164396,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),448.35,224.18,134.51,609.76,28
CDM,SUP-164650,RETR SURG 6.25 SET 10MM,654.59,327.3,196.38,392.75,2
CDM,SUP-164655,FRCP SURG 9.75IN FORSTR-BALL,654.07,327.04,196.22,392.44,2
CDM,SUP-164694,FRCP SURG 10 UT TENACLUM STD,6610.89,3305.45,1983.27,3966.53,2
CDM,SUP-164718,SCISS SURG STRLLY 8.75IN SS,3149.0,1574.5,944.7,1889.4,2
CDM,SUP-164727,FRCP SURG 7 TISS 3X4 TEETH,472.98,236.49,141.9,283.79,2
CDM,SUP-164767,SPTLA SURG 13.125 INTEST MALL,3046.34,1523.17,913.9,1827.8,2
CDM,SUP-164769,SCISS SURG STVN TNTM CRV 5IN,6432.0,3216.0,1929.6,3859.2,2
CDM,SUP-164783,SILK SURG TAPE 1INX1.5Y 100/BX,5494.0,2747.0,1648.2,3296.4,2
CDM,SUP-164785,PLSTC SURG TAPE 1INX1.5Y 100BX,2135.0,1067.5,640.5,1281.0,2
CDM,SUP-164786,PLSTC SURG TAPE 2INX1.5Y 100BX,7757.05,3878.53,2327.12,4654.23,2
CDM,SUP-164794,NEUROLINE INOJCT NEDL 50MM 25G,4020.0,2010.0,1206.0,2412.0,2
CDM,SUP-164809,TRAY DRN 8.5X15 PLEURL,20574.0,10287.0,6172.2,12344.4,2
CDM,SUP-164879,JOINT DEVICE (IMPLANTABLE),2912.49,1456.25,873.75,3960.99,28
CDM,SUP-164880,IMP ANKL JNT TIB CPNT SZ-4,619.15,309.58,154.79,408.64,16
CDM,SUP-164881,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",341.6,170.8,102.48,464.58,28
CDM,SUP-164882,CATH BLN PERI 6FX6X75X8 OTW NC,341.6,170.8,85.4,225.46,16
CDM,SUP-165441,CUSTOM PACK W/ OXYGENATOR,854.0,427.0,213.5,563.64,16
CDM,SUP-166235,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",23911.56,11955.78,2630.27,32519.72,32
CDM,SUP-166282,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",640.5,320.25,192.15,871.08,28
CDM,SUP-166287,EP CATHETER 12 FR X 107 CM,341.6,170.8,85.4,225.46,16
CDM,SUP-166294,"PORT, INDWELLING (IMPLANTABLE)",2814.0,1407.0,844.2,3827.04,28
CDM,SUP-166298,DISSECTOR LIGASURE EXACT,736.29,368.15,184.07,485.95,16
CDM,SUP-166300,GWIRE VASC 145CM .018IN FLX TP,2613.0,1306.5,653.25,1724.58,16
CDM,SUP-166306,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-166310,TRAXI PANNICULOUS RETRACTOR,854.0,427.0,213.5,563.64,16
CDM,SUP-166311,TRAXI PANNICULOUS EXTENDER,854.0,427.0,213.5,563.64,16
CDM,SUP-166314,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",854.0,427.0,256.2,1161.44,28
CDM,SUP-166322,CASPIAN SNGL ADJUST DRILL 2.3,9112.72,4556.36,2278.18,6014.39,16
CDM,SUP-166328,YUKON SINGLE 2.8MM ADJ DRILL,6432.0,3216.0,1608.0,4245.12,16
CDM,SUP-166344,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-166347,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-166350,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3417.0,1708.5,1025.1,4647.12,28
CDM,SUP-166353,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),854.0,427.0,256.2,1161.44,28
CDM,SUP-166361,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2613.0,1306.5,783.9,3553.68,28
CDM,SUP-166362,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1398.43,699.21,419.53,1901.86,28
CDM,SUP-166363,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),725.9,362.95,217.77,987.22,28
CDM,SUP-166364,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),725.9,362.95,217.77,987.22,28
CDM,SUP-166366,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1174.25,587.13,352.28,1596.98,28
CDM,SUP-166368,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3055.2,1527.6,916.56,4155.07,28
CDM,SUP-166369,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3055.2,1527.6,916.56,4155.07,28
CDM,SUP-166373,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),802.76,401.38,240.83,1091.75,28
CDM,SUP-166375,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),26346.15,13173.08,2898.08,35830.76,28
CDM,SUP-166970,HET BIPOLAR FORCEPS,692.59,346.3,173.15,457.11,16
CDM,SUP-167083,CATH PERIPHERAL 5FR X 100CM,6.69,3.35,1.67,4.42,16
CDM,SUP-167084,DRILL CANNULATED 2.7MM,4104.42,2052.21,1026.11,2708.92,16
CDM,SUP-167157,"CATHETER, TRANSLUMINAL ANGIOPLASTY, DRUG-COATED, NON-LASER",794.22,397.11,238.27,1080.14,28
CDM,SUP-167879,CANNULA OSTIAL L2.3IN TIP L5MM,823.68,411.84,205.92,543.63,16
CDM,SUP-167880,CANNULA OSTIAL L2.3IN TIP L6MM,3324.54,1662.27,831.14,2194.2,16
CDM,SUP-167881,CANN FEMORAL ADLT 15F BIO-MEDI,3324.54,1662.27,831.14,2194.2,16
CDM,SUP-167882,CANN FEMORAL ADLT 17F BIO-MEDI,3991.79,1995.9,997.95,2634.58,16
CDM,SUP-167883,CANN FEMORAL BIO-MEDICUS 19FR,19601.88,9800.94,4900.47,12937.24,16
CDM,SUP-168299,"PROSTHESIS, BREAST (IMPLANTABLE)",2343.08,1171.54,702.92,3186.59,28
CDM,SUP-168300,"PROSTHESIS, BREAST (IMPLANTABLE)",2343.08,1171.54,702.92,3186.59,28
CDM,SUP-168301,"PROSTHESIS, BREAST (IMPLANTABLE)",2343.08,1171.54,702.92,3186.59,28
CDM,SUP-168302,"PROSTHESIS, BREAST (IMPLANTABLE)",2404.88,1202.44,721.46,3270.64,28
CDM,SUP-168303,"PROSTHESIS, BREAST (IMPLANTABLE)",2343.08,1171.54,702.92,3186.59,28
CDM,SUP-168304,"PROSTHESIS, BREAST (IMPLANTABLE)",3187.62,1593.81,956.29,4335.16,28
CDM,SUP-168305,"PROSTHESIS, BREAST (IMPLANTABLE)",3798.9,1899.45,1139.67,5166.5,28
CDM,SUP-168307,"PROSTHESIS, BREAST (IMPLANTABLE)",79420.0,39710.0,8736.2,108011.2,28
CDM,SUP-168308,"PROSTHESIS, BREAST (IMPLANTABLE)",63175.0,31587.5,6949.25,85918.0,28
CDM,SUP-168310,"PROSTHESIS, BREAST (IMPLANTABLE)",469.7,234.85,140.91,638.79,28
CDM,SUP-168311,"PROSTHESIS, BREAST (IMPLANTABLE)",3055.2,1527.6,916.56,4155.07,28
CDM,SUP-168528,DISP KT 3X8 PEEK TENODEIS SCRW,20269.2,10134.6,5067.3,13377.67,16
CDM,SUP-168983,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",849.73,424.87,254.92,1155.63,28
CDM,SUP-169091,STPL RELOAD VASC 30 8 SM SRT,125.98,62.99,31.5,83.15,16
CDM,SUP-169098,OSTIAL FLASH BALLOON 4.5X8MM,2746.6,1373.3,686.65,1812.76,16
CDM,SUP-169138,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-169139,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1281.0,640.5,384.3,1742.16,28
CDM,SUP-169140,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",2814.0,1407.0,844.2,3827.04,28
CDM,SUP-169141,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-169147,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",1622.6,811.3,486.78,2206.74,28
CDM,SUP-169160,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",6432.0,3216.0,1929.6,8747.52,28
CDM,SUP-169162,"PROSTHESIS, BREAST (IMPLANTABLE)",2814.0,1407.0,844.2,3827.04,28
CDM,SUP-169182,CATH PTCA 2.00X12 OTW,5427.0,2713.5,1356.75,3581.82,16
CDM,SUP-169186,CATH PTCA 2.25X12 OTW,3417.0,1708.5,854.25,2255.22,16
CDM,SUP-169193,CATH PTCA 2.00X12 RX NC,11243.31,5621.66,2810.83,7420.58,16
CDM,SUP-169194,CATH PTCA 2.00X15 RX NC,2743.01,1371.5,685.75,1810.39,16
CDM,SUP-169195,CATH PTCA 2.00X21 RX NC,6532.5,3266.25,1633.13,4311.45,16
CDM,SUP-169196,CATH PTCA 2.00X8 RX NC,222.72,111.36,55.68,147.0,16
CDM,SUP-169427,"PROSTHESIS, URINARY SPHINCTER (IMPLANTABLE)",53247.5,26623.75,5857.23,72416.6,28
CDM,SUP-169437,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),9239.74,4619.87,1016.37,12566.04,28
CDM,SUP-169446,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170151,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170152,BIT DRL SLD,2814.0,1407.0,703.5,1857.24,16
CDM,SUP-170153,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170154,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170155,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170156,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170157,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170158,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170159,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170161,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170177,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-170197,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",3046.34,1523.17,913.9,4143.02,28
CDM,SUP-170212,CATH AND LOADER AIRWAY ENDBR,2613.0,1306.5,653.25,1724.58,16
CDM,SUP-170227,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4.64,2.32,1.39,6.31,28
CDM,SUP-170232,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",6432.0,3216.0,1929.6,8747.52,28
CDM,SUP-170233,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",6432.0,3216.0,1929.6,8747.52,28
CDM,SUP-170983,JOINT DEVICE (IMPLANTABLE),298.9,149.45,89.67,406.5,28
CDM,SUP-170989,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),619.15,309.58,185.75,842.04,28
CDM,SUP-170991,"GRAFIX CORE AND GRAFIXPL CORE, PER SQUARE CENTIMETER",619.15,309.58,160.23,842.04,28
CDM,SUP-170995,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6532.5,3266.25,1959.75,8884.2,28
CDM,SUP-171318,PRBE ELECSURG MNPLR 11,491.05,245.53,122.76,324.09,16
CDM,SUP-171321,JOINT DEVICE (IMPLANTABLE),6222.06,3111.03,1866.62,8461.99,28
CDM,SUP-171322,JOINT DEVICE (IMPLANTABLE),10029.9,5014.95,1103.29,13640.66,28
CDM,SUP-171512,BIT DRL 4.7 CANN SS,704.55,352.28,176.14,465.0,16
CDM,SUP-171536,JOINT DEVICE (IMPLANTABLE),3374.59,1687.3,1012.38,4589.44,28
CDM,SUP-171548,NDL PLM 18GAX20CM,8401.8,4200.9,2100.45,5545.19,16
CDM,SUP-171550,CATH BLN PERI 5FX4.0X80X135,2814.0,1407.0,703.5,1857.24,16
CDM,SUP-171555,CATH BLN PERI 4FX5.0X80X130,5728.5,2864.25,1432.13,3780.81,16
CDM,SUP-171569,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",854.0,427.0,256.2,1161.44,28
CDM,SUP-171574,CATH SUPRT 0.018X150 NVC ANGL,362.95,181.48,90.74,239.55,16
CDM,SUP-171575,CATH DIAG PERIPH 4FX150 RDPQ,747.25,373.63,186.81,493.19,16
CDM,SUP-171588,FCP RBTC DVN MARYLND MTRX,2412.0,1206.0,603.0,1591.92,16
CDM,SUP-171614,CATH ARTHCTMY LNR VAC TUB 2.0,13788.39,6894.2,3447.1,9100.34,16
CDM,SUP-171959,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",1814.75,907.38,544.43,2468.06,28
CDM,SUP-171961,KT INSRT SNS BLN CATH 8FX50CC,1814.75,907.38,453.69,1197.74,16
CDM,SUP-171963,CATH THRMB IND 115 8+,1814.75,907.38,453.69,1197.74,16
CDM,SUP-171965,CATH THRMB IND 115 12+,1814.75,907.38,453.69,1197.74,16
CDM,SUP-171990,BSKT SPC RTV RSC 2.5X230,1814.75,907.38,453.69,1197.74,16
CDM,SUP-172005,TR CHST TB THL DRN 28FX41,1814.75,907.38,453.69,1197.74,16
CDM,SUP-172009,PUNCH BIOP ACP RAZOR SHARP 7,1814.75,907.38,453.69,1197.74,16
CDM,SUP-172011,PUNCH BIOP TRP STR SHARP 5,1814.75,907.38,453.69,1197.74,16
CDM,SUP-172013,KIT TEMPLATE SPNL,1814.75,907.38,453.69,1197.74,16
CDM,SUP-172017,KT ENDOBRONC ILL 45DEG CATH,3195.9,1597.95,798.98,2109.29,16
CDM,SUP-172020,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172022,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172024,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172026,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172028,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172032,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172033,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172035,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172037,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172039,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172041,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172043,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172045,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172046,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172048,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172049,JOINT DEVICE (IMPLANTABLE),1814.75,907.38,544.43,2468.06,28
CDM,SUP-172063,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172064,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172067,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172068,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172069,JOINT DEVICE (IMPLANTABLE),3195.9,1597.95,958.77,4346.42,28
CDM,SUP-172632,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),448.35,224.18,134.51,609.76,28
CDM,SUP-172633,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),448.35,224.18,134.51,609.76,28
CDM,SUP-173058,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1297.31,648.66,389.19,1764.34,28
CDM,SUP-173059,CATH BLN PERI 6.0X60 OTW,1297.31,648.66,324.33,856.22,16
CDM,SUP-173060,JOINT DEVICE (IMPLANTABLE),1297.31,648.66,389.19,1764.34,28
CDM,SUP-173062,CATH ATH RTP BURR TIP 1.25X135,717.36,358.68,179.34,473.46,16
CDM,SUP-173063,CATH ATH RTP BURR TIP 1.5X135,538.02,269.01,134.51,355.09,16
CDM,SUP-173066,PRBE CAUT SERFAS 50-S RF 133,762.34,381.17,190.58,503.14,16
CDM,SUP-173067,JOINT DEVICE (IMPLANTABLE),672.53,336.26,201.76,914.64,28
CDM,SUP-173068,JOINT DEVICE (IMPLANTABLE),896.7,448.35,269.01,1219.51,28
CDM,SUP-173464,JOINT DEVICE (IMPLANTABLE),232.0,116.0,69.6,315.52,28
CDM,SUP-173465,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1708.0,854.0,512.4,2322.88,28
CDM,SUP-173471,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),264.74,132.37,79.42,360.05,28
CDM,SUP-173485,JOINT DEVICE (IMPLANTABLE),7839.0,3919.5,2351.7,10661.04,28
CDM,SUP-173488,JOINT DEVICE (IMPLANTABLE),92.99,46.5,27.9,126.47,28
CDM,SUP-173489,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),160.29,80.15,48.09,218.0,28
CDM,SUP-173540,ELSTMRC MEM PWR CHAIN SRT 2M,7519.41,3759.71,2255.82,4511.65,2
CDM,SUP-173656,ADH VNS VENASEAL CLSR SYS,3055.2,1527.6,916.56,1833.12,2
CDM,SUP-173661,KT TRACH BVN FM CUF 5.0MM TUBE,2613.0,1306.5,783.9,1567.8,2
CDM,SUP-173663,KT TRACH BVN FM CUF 9.0MM TUBE,4212.96,2106.48,1263.89,2527.78,2
CDM,SUP-173667,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",9535.44,4767.72,2860.63,12968.2,28
CDM,SUP-173668,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",9535.44,4767.72,2860.63,12968.2,28
CDM,SUP-173696,JOINT DEVICE (IMPLANTABLE),2412.0,1206.0,723.6,3280.32,28
CDM,SUP-173698,JOINT DEVICE (IMPLANTABLE),222.72,111.36,66.82,302.9,28
CDM,SUP-173705,JOINT DEVICE (IMPLANTABLE),1500.22,750.11,450.07,2040.3,28
CDM,SUP-173725,JOINT DEVICE (IMPLANTABLE),232.0,116.0,69.6,315.52,28
CDM,SUP-173728,JOINT DEVICE (IMPLANTABLE),4020.0,2010.0,1206.0,5467.2,28
CDM,SUP-173736,JOINT DEVICE (IMPLANTABLE),2814.0,1407.0,844.2,3827.04,28
CDM,SUP-173742,JOINT DEVICE (IMPLANTABLE),3095.4,1547.7,928.62,4209.74,28
CDM,SUP-173743,JOINT DEVICE (IMPLANTABLE),55445.48,27722.74,6099.0,75405.85,28
CDM,SUP-173744,JOINT DEVICE (IMPLANTABLE),55445.48,27722.74,6099.0,75405.85,28
CDM,SUP-173747,JOINT DEVICE (IMPLANTABLE),5628.0,2814.0,1688.4,7654.08,28
CDM,SUP-173750,JOINT DEVICE (IMPLANTABLE),7035.0,3517.5,2110.5,9567.6,28
CDM,SUP-173751,JOINT DEVICE (IMPLANTABLE),3216.0,1608.0,964.8,4373.76,28
CDM,SUP-173769,JOINT DEVICE (IMPLANTABLE),320.25,160.13,96.08,435.54,28
CDM,SUP-173770,JOINT DEVICE (IMPLANTABLE),320.25,160.13,96.08,435.54,28
CDM,SUP-174380,GRFT TISS ART 4-5MMX10-20CM,536.35,268.18,134.09,353.99,16
CDM,SUP-174389,JOINT DEVICE (IMPLANTABLE),16764.0,8382.0,1844.04,22799.04,28
CDM,SUP-174390,JOINT DEVICE (IMPLANTABLE),16764.0,8382.0,1844.04,22799.04,28
CDM,SUP-174391,JOINT DEVICE (IMPLANTABLE),18021.3,9010.65,1982.34,24508.97,28
CDM,SUP-174392,JOINT DEVICE (IMPLANTABLE),18021.3,9010.65,1982.34,24508.97,28
CDM,SUP-174393,JOINT DEVICE (IMPLANTABLE),18021.3,9010.65,1982.34,24508.97,28
CDM,SUP-174394,JOINT DEVICE (IMPLANTABLE),16764.0,8382.0,1844.04,22799.04,28
CDM,SUP-174402,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174404,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174405,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174406,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174408,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174414,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174415,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174418,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174419,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",4623.0,2311.5,1386.9,6287.28,28
CDM,SUP-174427,JOINT DEVICE (IMPLANTABLE),193.53,96.77,58.06,263.2,28
CDM,SUP-174667,CATH BLN PERI 5.0X40X80 OTW,2075.0,1037.5,518.75,1369.5,16
CDM,SUP-174669,CATH BLN PERI 5.0X100X80 OTW,2075.0,1037.5,518.75,1369.5,16
CDM,SUP-174672,CATH BLN PERI 7.0X40X80 OTW,11410.95,5705.48,2852.74,7531.23,16
CDM,SUP-174675,CATH BLN PERI 4.0X150X90 OTW,30415.23,15207.62,7603.81,20074.05,16
CDM,SUP-174933,STPLR INT USE SRF 45 INST,2729.3,1364.65,682.33,1801.34,16
CDM,SUP-174934,STPL RLD INT USE SRF 6RW BLU,2729.3,1364.65,682.33,1801.34,16
CDM,SUP-174936,STPL RLD INT USE SRF 6RW WHT,2959.97,1479.99,739.99,1953.58,16
CDM,SUP-175136,CATH ENDO DIL G21664 8.5X200,3706.44,1853.22,926.61,2446.25,16
CDM,SUP-175137,CATH ENDO DIL G21603 12X200,5724.48,2862.24,1431.12,3778.16,16
CDM,SUP-175371,JOINT DEVICE (IMPLANTABLE),7236.0,3618.0,2170.8,9840.96,28
CDM,SUP-175374,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1281.0,640.5,384.3,1742.16,28
CDM,SUP-175375,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1281.0,640.5,384.3,1742.16,28
CDM,SUP-175630,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",160.03,80.02,48.01,217.64,28
CDM,SUP-175710,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",5025.0,2512.5,1507.5,6834.0,28
CDM,SUP-175711,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",5326.5,2663.25,1597.95,7244.04,28
CDM,SUP-175712,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",7035.0,3517.5,2110.5,9567.6,28
CDM,SUP-175713,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",5326.5,2663.25,1597.95,7244.04,28
CDM,SUP-175714,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",7035.0,3517.5,2110.5,9567.6,28
CDM,SUP-176001,SPINEJACK EXPANSION KIT 5.0MM,444.08,222.04,111.02,293.09,16
CDM,SUP-176003,SPINEJACK EXPANSION KIT 5.8MM,294.2,147.1,73.55,194.17,16
CDM,SUP-176004,SPINEJACK PREPARATION KT 5.8MM,248.94,124.47,62.24,164.3,16
CDM,SUP-176423,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),5623.98,2811.99,1687.19,7648.61,28
CDM,SUP-176424,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",6025.98,3012.99,1807.79,8195.33,28
CDM,SUP-176426,KIT NERV URNRY CTL REV,6025.98,3012.99,1506.5,3977.15,16
CDM,SUP-176427,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",5623.98,2811.99,1687.19,7648.61,28
CDM,SUP-176430,CATH GD COR 7FX130 GW PEBAX,6025.98,3012.99,1506.5,3977.15,16
CDM,SUP-176433,CATH DIAG PERIPH 5FX100 RDPQ,5623.98,2811.99,1406.0,3711.83,16
CDM,SUP-176809,ELECTRD UNIPLR 24F LNG URO,640.5,320.25,160.13,422.73,16
CDM,SUP-176810,CTRL AMMONIA ALN,60.32,30.16,18.1,36.19,2
CDM,SUP-176811,KT CANNABINOIDS ALN,555.1,277.55,166.53,333.06,2
CDM,SUP-176812,CTRL CRP ALN,555.1,277.55,166.53,333.06,2
CDM,SUP-176815,SET CTRL ALN MC III,2793.9,1396.95,838.17,1676.34,2
CDM,SUP-176817,CONTROL 1 LIPASE ALN OC,982.1,491.05,294.63,589.26,2
CDM,SUP-176818,CONTROL 2LIPASE NG ALN,2062.41,1031.21,618.72,1237.45,2
CDM,SUP-176819,CTRL MICROALBUMIN ALN,896.7,448.35,269.01,538.02,2
CDM,SUP-176820,SET OXYCODONE ALN,896.7,448.35,269.01,538.02,2
CDM,SUP-176821,KT VITAMIN D ALN US,896.5,448.25,268.95,537.9,2
CDM,SUP-176823,CTRL ANTI CCP ALN,633.75,316.88,190.13,380.25,2
CDM,SUP-177303,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",2912.89,1456.45,873.87,3961.53,28
CDM,SUP-177304,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",2912.89,1456.45,873.87,3961.53,28
CDM,SUP-177631,CATH BLN PERI 7FX9.0X20X75 OTW,6898.32,3449.16,2069.5,4138.99,2
CDM,SUP-177644,BNDG WND CRD ADH 7/8,56569.6,28284.8,16970.88,33941.76,2
CDM,SUP-177646,EMBL PRE FILLED SYR 2ML 1300UM,56569.6,28284.8,16970.88,33941.76,2
CDM,SUP-177649,EMBL PRE FILLED SYR 3ML 75UM,5728.5,2864.25,1718.55,3437.1,2
CDM,SUP-177650,EMBL PRE FILLED SYR 3ML 100UM,5728.5,2864.25,1718.55,3437.1,2
CDM,SUP-177677,HOOK SKN 1 PRONG 6.5,45125.0,22562.5,13537.5,27075.0,2
CDM,SUP-177679,SURGISCOPE NEURO ARR 8X100,45125.0,22562.5,13537.5,27075.0,2
CDM,SUP-177680,SURGISCOPE NEURO ARR 8X130,48735.0,24367.5,14620.5,29241.0,2
CDM,SUP-177685,EVAC COAG ARR SFT TISS 12FX100,45125.0,22562.5,13537.5,27075.0,2
CDM,SUP-177692,CATH URETH DCB INFLATE 18FX5,45125.0,22562.5,11281.25,29782.5,16
CDM,SUP-177697,CATH URETH DCB INFLATE 36FX3,45125.0,22562.5,11281.25,29782.5,16
CDM,SUP-177700,CATH URETH DCB BASIC 24FX5,48735.0,24367.5,12183.75,32165.1,16
CDM,SUP-177965,POSTERIOR CHAMBER INTRAOCULAR LENS,64980.0,32490.0,145.73,40157.64,28
CDM,SUP-177968,POSTERIOR CHAMBER INTRAOCULAR LENS,546.56,273.28,145.73,360.73,28
CDM,SUP-177969,POSTERIOR CHAMBER INTRAOCULAR LENS,533.75,266.88,145.73,352.28,28
CDM,SUP-177970,POSTERIOR CHAMBER INTRAOCULAR LENS,533.75,266.88,145.73,352.28,28
CDM,SUP-177971,POSTERIOR CHAMBER INTRAOCULAR LENS,1894.36,947.18,145.73,1250.28,28
CDM,SUP-177974,POSTERIOR CHAMBER INTRAOCULAR LENS,1052.98,526.49,145.73,694.97,28
CDM,SUP-177976,POSTERIOR CHAMBER INTRAOCULAR LENS,9967.59,4983.8,145.73,6159.97,28
CDM,SUP-177983,POSTERIOR CHAMBER INTRAOCULAR LENS,4783.8,2391.9,145.73,3157.31,28
CDM,SUP-177984,POSTERIOR CHAMBER INTRAOCULAR LENS,619.15,309.58,145.73,408.64,28
CDM,SUP-177989,POSTERIOR CHAMBER INTRAOCULAR LENS,555.1,277.55,145.73,366.37,28
CDM,SUP-177990,POSTERIOR CHAMBER INTRAOCULAR LENS,555.1,277.55,145.73,366.37,28
CDM,SUP-177992,POSTERIOR CHAMBER INTRAOCULAR LENS,372.34,186.17,111.7,245.75,28
CDM,SUP-178029,BUR SURG DISSCT FLUT 3X14,769.67,384.84,192.42,507.98,16
CDM,SUP-178030,BUR SURG DISSCT FLUT 2.2X15,315.98,157.99,79.0,208.55,16
CDM,SUP-178427,CATH OCCL UPS CROSS 4FX80,10096.5,5048.25,2524.13,6663.69,16
CDM,SUP-178428,CATH OCCL UPS CROSS 4FX120,232.0,116.0,58.0,153.12,16
CDM,SUP-178429,CATH OCCL UPS CROSS 2.9FX80,8442.0,4221.0,2110.5,5571.72,16
CDM,SUP-178466,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),6825.96,3412.98,2047.79,9283.31,28
CDM,SUP-178576,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",2412.0,1206.0,723.6,3280.32,28
CDM,SUP-178596,CANN BM 25FX76.2 FEM ADLT,545.28,272.64,136.32,359.88,16
CDM,SUP-178609,SZR BRST SIL 340CC STYL SRLP,718.43,359.22,179.61,474.16,16
CDM,SUP-178615,SZR BRST SIL 640CC STY SRM,514.11,257.06,128.53,339.31,16
CDM,SUP-178630,KT COMBO NVS ENDOMET,2037.28,1018.64,509.32,1344.6,16
CDM,SUP-178631,DEVICE ENDOMET ABL V5,2793.9,1396.95,698.48,1843.97,16
CDM,SUP-178634,STAPLER RLD 0.5X3MM TI NON ABS,1259.65,629.83,314.91,831.37,16
CDM,SUP-178686,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",4212.96,2106.48,1263.89,5729.63,28
CDM,SUP-178692,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",9750.0,4875.0,2925.0,13260.0,28
CDM,SUP-178696,SYS CALIB FREE BRV REFLUX TEST,29809.44,14904.72,7452.36,19674.23,16
CDM,SUP-178698,FORCEP DESSI BIPOLAR MCR NSL,5579.76,2789.88,1673.93,3347.86,2
CDM,SUP-178705,CATH URODYNAMIC TDC BLDR 7FX6,1242.01,621.01,372.6,745.21,2
CDM,SUP-178731,CATH PTCA 3.25X8X145 RX NC,783.12,391.56,195.78,516.86,16
CDM,SUP-178733,CATH PTCA 3.25X15X145 RX NC,12954.0,6477.0,3238.5,8549.64,16
CDM,SUP-178736,CATH PTCA 3.5X8X145 RX NC,1498.94,749.47,374.74,989.3,16
CDM,SUP-178740,CATH PTCA 3.5X25X145 RX NC,2135.0,1067.5,533.75,1409.1,16
CDM,SUP-178752,CATH PTCA 4.5X20X145 RX NC,384.3,192.15,96.08,253.64,16
CDM,SUP-178756,CATH PTCA 5.0X20X145 RX NC,2211.0,1105.5,552.75,1459.26,16
CDM,SUP-178757,CATH PTCA 5.5X12X145 RX NC,768.6,384.3,192.15,507.28,16
CDM,SUP-178758,CATH PTCA 5.5X15X145 RX NC,16002.0,8001.0,4000.5,10561.32,16
CDM,SUP-178759,CATH PTCA 5.5X20X145 RX NC,20574.0,10287.0,5143.5,13578.84,16
CDM,SUP-178761,CATH PTCA 6.0X15X145 RX NC,640.5,320.25,160.13,422.73,16
CDM,SUP-178764,CATHETER PTCA 3.0X10 RX NC,3417.0,1708.5,854.25,2255.22,16
CDM,SUP-178795,CATH INTRVSC ULTRASND 6F,3618.0,1809.0,904.5,2387.88,16
CDM,SUP-178804,ELECTRD LOOP PLASMA 24F,768.6,384.3,192.15,507.28,16
CDM,SUP-178810,"GRAFT, VASCULAR",469.7,234.85,140.91,638.79,28
CDM,SUP-178811,"GRAFT, VASCULAR",469.7,234.85,140.91,638.79,28
CDM,SUP-178813,"GRAFT, VASCULAR",3497.4,1748.7,1049.22,4756.46,28
CDM,SUP-178814,"GRAFT, VASCULAR",3316.5,1658.25,994.95,4510.44,28
CDM,SUP-178817,"GRAFT, VASCULAR",3316.5,1658.25,994.95,4510.44,28
CDM,SUP-179004,SET NEPHRO XFR BLNCATH 8X15,136.42,68.21,34.11,90.04,16
CDM,SUP-179006,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",68.21,34.1,20.46,92.76,28
CDM,SUP-179007,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",672.53,336.26,201.76,914.64,28
CDM,SUP-179020,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",3216.0,1608.0,964.8,4373.76,28
CDM,SUP-179399,KT BIOP TRK BNE LES 13GAX19.8,269.01,134.51,67.25,177.55,16
CDM,SUP-179410,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",264.74,132.37,79.42,360.05,28
CDM,SUP-179413,LAMP 175 WATT,264.74,132.37,66.19,174.73,16
CDM,SUP-179438,FILL NACL RST 1ML,264.74,132.37,66.19,174.73,16
CDM,SUP-179439,FILL SIL RST 1ML,256.2,128.1,64.05,169.09,16
CDM,SUP-179440,FILL W/ RST 1ML,256.2,128.1,64.05,169.09,16
CDM,SUP-179449,"PACEMAKER, SINGLE CHAMBER, NON RATE-RESPONSIVE (IMPLANTABLE)",555.1,277.55,166.53,754.94,28
CDM,SUP-179450,"PACEMAKER, SINGLE CHAMBER, NON RATE-RESPONSIVE (IMPLANTABLE)",555.1,277.55,166.53,754.94,28
CDM,SUP-179451,TRAY MITRAL VALVE EPS,9306.3,4653.15,2326.58,6142.16,16
CDM,SUP-179452,FILL LIDO PFS RST 1ML,1506.44,753.22,376.61,994.25,16
CDM,SUP-179454,KT ANTGN TST COVID FLOWFLEX,23622.0,11811.0,7086.6,14173.2,2
CDM,SUP-179455,BLN ESCP BS 3/DBES 1USE,23622.0,11811.0,5905.5,15590.52,16
CDM,SUP-179456,TB INFL DIL 16504618,273.28,136.64,68.32,180.36,16
CDM,SUP-179671,CATH DIL 15-18X5.5 M00550310,258.19,129.1,64.55,170.41,16
CDM,SUP-179686,PRBE ESOPH PUR TEMP 7 ELECTR,9648.0,4824.0,2412.0,6367.68,16
CDM,SUP-179687,CATH DIAG COR 6FX100 RT-3.5 GW,9648.0,4824.0,2412.0,6367.68,16
CDM,SUP-179690,"ALLODERM, PER SQUARE CENTIMETER",2101.58,1050.79,160.23,2858.15,28
CDM,SUP-179691,PRESSZR CMNT 23 DEGREE,2101.58,1050.79,525.4,1387.04,16
CDM,SUP-179693,BLDE ENT SHAVER PLL STR 3,19601.88,9800.94,4900.47,12937.24,16
CDM,SUP-179696,BLDE ENT SHAVER PLL 40D ANGL 4,2311.5,1155.75,577.88,1525.59,16
CDM,SUP-179918,KT SNARE ATR MNI 4-8X175,7437.0,3718.5,1859.25,4908.42,16
CDM,SUP-179919,KT SNARE ATR 3L 6-10X120,7437.0,3718.5,1859.25,4908.42,16
CDM,SUP-179920,KT SNARE ATR 9-15X120,7437.0,3718.5,1859.25,4908.42,16
CDM,SUP-179922,KT VASCULAR SNARE HL 6FX20X120,2998.92,1499.46,749.73,1979.29,16
CDM,SUP-179923,KT VASCULAR SNARE HL 6FX25X65,2882.34,1441.17,720.59,1902.34,16
CDM,SUP-179924,KT VASCULAR SNARE HL 6FX25X120,2882.34,1441.17,720.59,1902.34,16
CDM,SUP-179926,SYS BIPOLAR SEALING RF,32.48,16.24,8.12,21.44,16
CDM,SUP-179928,CATH THRMB TRV 4X41 1USE,61.43,30.72,15.36,40.54,16
CDM,SUP-179929,KT VASCULAR SNARE DEL SYST,729.855,364.92999999999995,182.35,481.41,16
CDM,SUP-179930,KT 1LOOP HL SNARE 3FX2X150X175,2954.7,1477.35,738.68,1950.1,16
CDM,SUP-180500,ELECTRD ABL 5 RF,39109.84,19554.92,9777.46,25812.49,16
CDM,SUP-180501,ELECTRD ABL 7 RF,6023.97,3011.99,1505.99,3975.82,16
CDM,SUP-180772,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",5205.9,2602.95,1561.77,7080.02,28
CDM,SUP-18123,ULTRA SLING III X-LARGE(11-0449-5) (NONSTOCK),118.32,59.16,29.58,78.09,16
CDM,SUP-18226,ENDO 21GA  VIZISHOT EBUS (NA-201SX-4021),446.42,223.21,111.61,294.64,16
CDM,SUP-193161,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",19030.95,9515.48,2093.4,25882.09,28
CDM,SUP-193161,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",2289.26,1144.63,686.78,3113.4,28
CDM,SUP-20875,EPIC MITRAL 29MM(E100-29M-00),7437.0,3718.5,1859.25,4596.07,16
CDM,SUP-20922,PACK PRIME SUPPORT ECMO/VAD (CB6M71R11) CS/1EA,7437.0,3718.5,1859.25,4908.42,16
CDM,SUP-21120,GUARDIA ACCESS ET EMBRYO TRANSFER(G53007),20231.1,10115.55,5057.78,13352.53,16
CDM,SUP-22679,ERBE JET 2 PUMP CARTRIDGE(20150-300),3819.0,1909.5,954.75,2520.54,16
CDM,SUP-22680,ENDO ERBE PROBE HYBRID 2.3MM(20150-215),3819.0,1909.5,954.75,2520.54,16
CDM,SUP-23571,"TUBE FEEDING MIC-KEY 12FR,0.8CM(8140-12-0.8)",3417.0,1708.5,854.25,2255.22,16
CDM,SUP-23572,"TUBE FEEDING MIC-KEY 12FR,1.0CM,3ML(8140-12-1.0)",3417.0,1708.5,854.25,2255.22,16
CDM,SUP-23994,PROTECTOR OPI EYE GUARD (DPC28300),1067.5,533.75,266.88,704.55,16
CDM,SUP-27488,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",53442.66,26721.33,1545.1,138797.36,28
CDM,SUP-27488,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",19853.91,9926.96,2183.93,27001.32,28
CDM,SUP-27489,POSTERIOR CHAMBER INTRAOCULAR LENS,1899.88,949.94,145.73,1253.92,28
CDM,SUP-27490,MESH (IMPLANTABLE),13824.25,6912.13,1520.67,18800.98,28
CDM,SUP-27491,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",19739.28,9869.64,2171.32,26845.42,28
CDM,SUP-27492,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",3737.84,1868.92,1121.35,5083.46,28
CDM,SUP-27493,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",20557.61,10278.805,1126.06,50438.25,28
CDM,SUP-27496,POSTERIOR CHAMBER INTRAOCULAR LENS,1375.14,687.57,145.73,907.59,28
CDM,SUP-27498,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",6333.51,3166.76,1900.05,8613.57,28
CDM,SUP-27498,"KERECIS OMEGA3, PER SQUARE CENTIMETER",4528.84,2264.42,160.23,6159.22,28
CDM,SUP-27500,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",652.81,326.41,195.84,887.83,28
CDM,SUP-3458,DRILL BIT 2.0MM (310.21),1306.32,653.16,326.58,862.17,16
CDM,SUP-72061,CUSTOM KIT INDEFLATOR,6112.13,3056.07,1528.03,4034.01,16
CDM,SUP-74901,LEEP ELECTRODE  5MM BALL  BX/5,212.98,106.49,53.24,140.57,16
HCPCS,0200T,"Injections of one side of sacrum for enlargement, 1 or more needles, accessed through the skin",11170.0,5585.0,3351.0,15191.2,32
HCPCS,0201T,"Injections of both sides of sacrum for enlargement, 2 or more needles, accessed through the skin",11282.0,5641.0,3384.6,15343.52,32
HCPCS,0483T,"Insertion of artificial valve between left heart chambers, accessed through the skin",90000.0,45000.0,18108.06,122400.0,32
HCPCS,0569T,"Repair of valve between upper right and lower right chambers of heart (tricuspid valve) using prosthesis delivered via catheter, accessed through skin; initial prosthesis",5428.0,2714.0,1628.4,19194.56,32
HCPCS,0571T,Insertion or replacement of implantable cardioverter-defibrillator system with electrodes under breastbone,99596.0,49798.0,27818.07,135450.56,30
HCPCS,0600T,"Irreversible electroporation destruction of growths of internal organ, accessed through skin",25248.0,12624.0,4587.63,34337.28,30
HCPCS,0620T,Insertion of stent to shunt arterial blood to deep vein of lower leg via catheter using imaging guidance,54728.0,27364.0,13425.43,74430.08,31
HCPCS,0646T,Implantation of artificial valve between right upper and lower chambers of heart through catheter,7500.0,3750.0,2250.0,19194.56,30
HCPCS,0649T,Quantitative magnetic resonance analysis of tissue composition with diagnostic MRI examination,2958.0,1479.0,302.84,4022.88,31
HCPCS,0673T,Laser destruction of benign growth of thyroid using imaging guidance,4950.0,2475.0,1485.0,6732.0,32
HCPCS,0686T,Acoustic energy destruction of malignant liver tissue using imaging guidance,38235.0,19117.5,488.25,51999.6,31
HCPCS,0698T,"Quantitative magnetic resonance for analysis of tissue composition of multiple organs obtained with diagnostic MRI of same anatomy, with interpretation and report",2972.0,1486.0,302.84,4041.92,31
HCPCS,0795T,Transcatheter insertion of permanent dual-chamber leadless pacemaker using fluoroscopy and device interrogation of right atrial and right ventricular pacemaker components,57778.0,28889.0,9875.67,78578.08,32
HCPCS,0823T,Insertion of permanent single-chamber leadless pacemaker for pacing the right upper heart chamber using imaging guidance,57838.0,28919.0,17351.4,78659.68,28
HCPCS,0866T,Quantitative MRI of the brain with comparison to previous MRI scan with MRI scan performed during the same visit,1854.0,927.0,307.22,2521.44,28
HCPCS,0913T,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, with imaging supervision, interpretation, and report, performed on a single major coronary artery or branch",17105.0,8552.5,5131.5,23262.8,26
HCPCS,0914T,"Transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon, performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement ",9408.0,4704.0,2822.4,12794.88,26
HCPCS,10004,"Fine needle aspiration biopsy, each additional growth",600.0,300.0,180.0,908.49,30
HCPCS,10005,"Fine needle aspiration biopsy using ultrasound guidance, first growth",3326.0,1663.0,857.07,4523.36,60
HCPCS,10006,"Fine needle aspiration biopsy using ultrasound guidance, each additional growth",1307.0,653.5,392.1,1777.52,60
HCPCS,10007,"Fine needle aspiration biopsy using fluoroscopic guidance, first growth",1465.0,732.5,439.5,1992.4,30
HCPCS,10008,"Fine needle aspiration biopsy using fluoroscopic guidance, each additional growth",650.0,325.0,195.0,908.49,30
HCPCS,10009,"Fine needle aspiration biopsy of growth using CT guidance, first growth",2063.0,1031.5,618.9,2805.68,30
HCPCS,10010,"Fine needle aspiration biopsy of growth using CT guidance, each additional growth",750.0,375.0,225.0,1020.0,30
HCPCS,10021,"Fine needle aspiration biopsy, first growth",1126.0,563.0,337.8,1531.36,30
HCPCS,10030,Drainage of fluid collection in soft tissue using imaging guidance,1500.0,750.0,450.0,2040.0,30
HCPCS,10035,"Placement of soft tissue locating device using X-ray, first growth",2176.0,1088.0,652.8,2959.36,30
HCPCS,10040,Acne surgery,415.0,207.5,124.5,564.4,30
HCPCS,10060,Simple or single drainage of skin abscess,1096.0,548.0,207.21,1490.56,96
HCPCS,10061,Complicated or multiple drainage of skin abscess,1403.0,701.5,207.21,1908.08,128
HCPCS,10080,Simple drainage of cyst of tailbone,1332.0,666.0,207.21,1811.52,96
HCPCS,10081,Complicated drainage of cyst of tailbone,1950.0,975.0,585.0,2652.0,96
HCPCS,10120,"Removal of foreign body from tissue, accessed beneath the skin, simple",1131.0,565.5,207.21,1538.16,96
HCPCS,10121,"Removal of foreign body from tissue, accessed beneath the skin, complex",3438.0,1719.0,1031.4,4675.68,32
HCPCS,10140,Drainage of blood or fluid accumulation,4113.0,2056.5,1233.9,5593.68,96
HCPCS,10160,"Aspiration of abscess, blood, or cyst",925.0,462.5,207.21,1258.0,128
HCPCS,10180,Complex drainage of wound infection after surgery,4923.0,2461.5,1274.65,6695.28,64
HCPCS,11042,"Removal of skin and tissue, 20.0 sq cm or less",1980.0,990.0,479.14,2692.8,96
HCPCS,11043,"Removal of muscle and/or tissue, 20.0 sq cm or less",2236.0,1118.0,479.14,3040.96,64
HCPCS,11044,"Removal of bone, 20.0 sq cm or less",3859.0,1929.5,1157.7,5248.24,64
HCPCS,11045,"Removal of skin and tissue, each additional 20.0 sq cm or less",1298.0,649.0,389.4,1765.28,64
HCPCS,11046,"Removal of muscle and/or tissue, each additional 20.0 sq cm or less",1827.0,913.5,548.1,2484.72,64
HCPCS,11047,"Removal of bone, each additional 20.0 sq cm or less",2094.0,1047.0,628.2,2847.84,32
HCPCS,11055,"Removal of noncancer thickened skin growth, 1 growth",429.0,214.5,128.7,583.44,32
HCPCS,11056,"Removal of noncancer thickened skin growth, 2-4 growths",431.0,215.5,129.3,586.16,32
HCPCS,11102,"Biopsy of related skin growth, first growth",1023.0,511.5,306.9,1391.28,32
HCPCS,11103,"Biopsy of related skin growth, each additional growth",713.0,356.5,213.9,969.68,32
HCPCS,11104,"Punch biopsy, first skin growth",1024.0,512.0,307.2,1392.64,64
HCPCS,11105,"Punch biopsy, each additional skin growth",648.0,324.0,194.4,881.28,32
HCPCS,11106,"Incision biopsy, first skin growth",1579.0,789.5,473.7,2147.44,32
HCPCS,11107,"Incision biopsy, each additional skin growth",550.0,275.0,165.0,748.0,32
HCPCS,11200,"Removal of skin tag, 1-15 skin tags",886.0,443.0,207.21,1204.96,64
HCPCS,11300,"Shaving of skin growth of body, arms, or legs, 0.5 cm or less",552.0,276.0,165.6,750.72,32
HCPCS,11301,"Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm",540.0,270.0,162.0,734.4,32
HCPCS,11302,"Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm",628.0,314.0,188.4,854.08,32
HCPCS,11303,"Shaving of skin growth of body, arms, or legs, more than 2.0 cm",753.0,376.5,207.21,1024.08,32
HCPCS,11305,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",535.0,267.5,160.5,727.6,32
HCPCS,11306,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",558.0,279.0,167.4,758.88,32
HCPCS,11307,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",580.0,290.0,174.0,788.8,32
HCPCS,11308,"Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm",825.0,412.5,207.21,1122.0,32
HCPCS,11310,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",543.0,271.5,162.9,738.48,32
HCPCS,11311,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",694.0,347.0,207.21,943.84,32
HCPCS,11312,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",725.0,362.5,207.21,986.0,32
HCPCS,11313,"Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm",775.0,387.5,207.21,1054.0,32
HCPCS,11400,"Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less",1210.0,605.0,363.0,1645.6,32
HCPCS,11401,"Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm",1650.0,825.0,495.0,2244.0,32
HCPCS,11402,"Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm",2613.0,1306.5,527.72,3553.68,64
HCPCS,11403,"Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm",3025.0,1512.5,527.72,4114.0,32
HCPCS,11404,"Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm",4950.0,2475.0,1485.0,6732.0,32
HCPCS,11406,"Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm",5019.0,2509.5,1505.7,6825.84,32
HCPCS,11420,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",2786.0,1393.0,835.8,3788.96,32
HCPCS,11421,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",2860.0,1430.0,527.72,3889.6,32
HCPCS,11422,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",3988.0,1994.0,1196.4,5423.68,32
HCPCS,11423,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",4524.0,2262.0,1357.2,6152.64,32
HCPCS,11424,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm",4688.0,2344.0,1406.4,6375.68,32
HCPCS,11426,"Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",6343.0,3171.5,1902.9,8626.48,32
HCPCS,11440,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less",1210.0,605.0,363.0,1645.6,32
HCPCS,11441,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",2375.0,1187.5,527.72,3230.0,32
HCPCS,11442,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",2750.0,1375.0,527.72,3740.0,32
HCPCS,11443,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",3036.0,1518.0,910.8,4128.96,32
HCPCS,11444,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",3170.0,1585.0,951.0,4311.2,32
HCPCS,11446,"Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm",4475.0,2237.5,1342.5,6086.0,32
HCPCS,11601,"Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm",1779.0,889.5,527.72,2419.44,32
HCPCS,11602,"Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm",2064.0,1032.0,523.42,2807.04,32
HCPCS,11603,"Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm",2390.0,1195.0,527.72,3250.4,32
HCPCS,11604,"Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm",3012.0,1506.0,903.6,4096.32,32
HCPCS,11606,"Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm",3749.0,1874.5,1124.7,5098.64,32
HCPCS,11622,"Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",2874.0,1437.0,527.72,3908.64,32
HCPCS,11642,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",2232.0,1116.0,527.72,3035.52,32
HCPCS,11643,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm",3408.0,1704.0,1022.4,4634.88,32
HCPCS,11644,"Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm",3611.0,1805.5,1083.3,4910.96,32
HCPCS,11719,Trimming of fingernails or toenails,167.0,83.5,50.1,227.12,32
HCPCS,11720,"Removal of fingernails or toenails, 1-5 nails",284.0,142.0,75.96,386.24,32
HCPCS,11721,"Removal of fingernails or toenails, 6 or more nails",358.0,179.0,75.96,486.88,32
HCPCS,11730,"Simple separation of fingernail or toenail from nail bed, first nail",619.0,309.5,83.37,841.84,96
HCPCS,11732,"Simple separation of fingernail or toenail from nail bed, each additional nail",207.0,103.5,62.1,281.52,32
HCPCS,11740,Removal of blood accumulation under fingernail or toenail,454.0,227.0,83.37,617.44,64
HCPCS,11750,Permanent removal fingernail or toenail,1307.0,653.5,392.1,1777.52,64
HCPCS,11755,Biopsy of fingernail or toenail,2177.0,1088.5,527.72,2960.72,32
HCPCS,11760,Repair of fingernail or toenail bed,1126.0,563.0,83.37,1531.36,64
HCPCS,11765,Removal of skin of fingernail or toenail,890.0,445.0,83.37,1210.4,64
HCPCS,11900,"Injection into skin growth, 1-7 growths",950.0,475.0,207.21,1292.0,32
HCPCS,11901,"Injection into skin growth, more than 7 growths",1219.0,609.5,207.21,1657.84,32
HCPCS,11976,Removal of implantable contraceptive capsules,1684.0,842.0,505.2,2290.24,32
HCPCS,11980,Placement of hormone pellet under skin,818.0,409.0,245.4,1112.48,32
HCPCS,11981,Insertion of drug delivery implant into tissue,446.0,223.0,133.8,606.56,32
HCPCS,11982,Removal of drug delivery implant from tissue,1032.0,516.0,207.21,1403.52,32
HCPCS,11983,Removal with reinsertion of drug delivery implant into tissue,1738.0,869.0,207.21,2363.68,64
HCPCS,12001,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less",847.0,423.5,228.76,1151.92,96
HCPCS,12002,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm",972.0,486.0,228.76,1321.92,96
HCPCS,12004,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 7.6-12.5 cm",1135.0,567.5,228.76,1543.6,64
HCPCS,12005,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 12.6-20.0 cm",1385.0,692.5,228.76,1883.6,64
HCPCS,12006,"Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm",1558.0,779.0,228.76,2118.88,64
HCPCS,12011,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",891.0,445.5,228.76,1211.76,96
HCPCS,12013,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",948.0,474.0,228.76,1289.28,96
HCPCS,12014,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1168.0,584.0,228.76,1588.48,64
HCPCS,12015,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1235.0,617.5,228.76,1679.6,64
HCPCS,12016,"Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 12.6-20.0 cm",1297.0,648.5,228.76,1763.92,64
HCPCS,12020,Simple closure of surface wound reopening,1404.0,702.0,421.2,1909.44,96
HCPCS,12021,Repair of separation of wound closure with insertion of packing,1210.0,605.0,363.0,1645.6,32
HCPCS,12031,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less",1037.0,518.5,311.1,1410.32,96
HCPCS,12032,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm",1367.0,683.5,410.1,1859.12,96
HCPCS,12034,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm",1680.0,840.0,479.14,2284.8,96
HCPCS,12035,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 12.6-20.0 cm",1764.0,882.0,479.14,2399.04,64
HCPCS,12037,"Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, more than 30.0 cm",3541.0,1770.5,479.14,4815.76,32
HCPCS,12041,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less",1008.0,504.0,302.4,1370.88,96
HCPCS,12042,"Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm",1250.0,625.0,375.0,1700.0,96
HCPCS,12044,"Intermediate repair of wound of neck, hands, feet, or genitals, 7.6-12.5 cm",1276.0,638.0,382.8,1735.36,32
HCPCS,12045,"Intermediate repair of wound of neck, hands, feet, or genitals, 12.6-20.0 cm",1644.0,822.0,479.14,2235.84,64
HCPCS,12051,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less",1185.0,592.5,355.5,1611.6,96
HCPCS,12052,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm",1293.0,646.5,387.9,1758.48,96
HCPCS,12053,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm",1384.0,692.0,415.2,1882.24,96
HCPCS,12054,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 7.6-12.5 cm",1437.0,718.5,431.1,1954.32,96
HCPCS,12056,"Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm",2256.0,1128.0,479.14,3068.16,64
HCPCS,13101,"Complicated repair of wound of trunk, 2.6-7.5 cm",2039.0,1019.5,527.72,2773.04,64
HCPCS,13102,"Complicated repair of wound of trunk, each additional 5.0 cm or less",1188.0,594.0,356.4,1615.68,32
HCPCS,13120,"Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm",1276.0,638.0,382.8,1735.36,32
HCPCS,13121,"Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm",1745.0,872.5,523.42,2373.2,64
HCPCS,13122,"Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less",741.0,370.5,222.3,1007.76,64
HCPCS,13131,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm",1419.0,709.5,425.7,1929.84,64
HCPCS,13132,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm",2099.0,1049.5,523.42,2854.64,64
HCPCS,13133,"Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less",674.0,337.0,202.2,916.64,64
HCPCS,13151,"Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm",2529.0,1264.5,527.72,3439.44,64
HCPCS,13152,"Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm",2734.0,1367.0,527.72,3718.24,64
HCPCS,13160,Extensive or complicated repair of surface wound reopening,3483.0,1741.5,1044.9,4736.88,32
HCPCS,14001,"Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm",4140.0,2070.0,1242.0,5630.4,32
HCPCS,14020,"Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less",3816.0,1908.0,1144.8,5189.76,32
HCPCS,14021,"Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm",3988.0,1994.0,1196.4,5423.68,32
HCPCS,14040,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less",4421.0,2210.5,1326.3,6012.56,32
HCPCS,14041,"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm",4478.0,2239.0,1343.4,6090.08,32
HCPCS,14060,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less",4601.0,2300.5,1380.3,6257.36,32
HCPCS,14061,"Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm",4780.0,2390.0,1434.0,6500.8,32
HCPCS,14301,"Repair of wound by transferring skin, 30.1-60.0 sq cm",6296.0,3148.0,1888.8,8562.56,32
HCPCS,15002,"Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",4259.0,2129.5,951.62,5792.24,32
HCPCS,15003,"Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",2086.0,1043.0,479.14,2836.96,32
HCPCS,15004,"Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less",1508.0,754.0,452.4,2050.88,32
HCPCS,15240,"Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less",3765.0,1882.5,1129.5,5120.4,32
HCPCS,15260,"Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less",4586.0,2293.0,1375.8,6236.96,32
HCPCS,15271,"Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less",4287.0,2143.5,792.6,8067.52,64
HCPCS,15272,"Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less",1857.0,928.5,334.2,3536.0,64
HCPCS,15273,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less",7560.0,3780.0,2268.0,10281.6,32
HCPCS,15274,"Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less",3110.0,1555.0,933.0,4229.6,32
HCPCS,15275,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less",4542.0,2271.0,951.62,7130.48,64
HCPCS,15276,"Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less",2427.0,1213.5,728.1,3300.72,32
HCPCS,15576,"Creation of flap graft to eyelids, nose, ears, lips, or mouth",3434.0,1717.0,1030.2,4670.24,32
HCPCS,15630,"Transfer of skin flap to eyelids, nose, ears, or lips",3266.0,1633.0,979.8,4441.76,32
HCPCS,15731,"Creation of flap graft to nose, forehead, temple, or scalp",6296.0,3148.0,1888.8,8562.56,32
HCPCS,15740,Creation of skin and tissue graft,2860.0,1430.0,858.0,3889.6,32
HCPCS,15781,Dermabrasion of skin of part of face,2200.0,1100.0,660.0,2992.0,32
HCPCS,15839,Removal of extra skin and tissue of other area,9277.0,4638.5,2243.66,12616.72,32
HCPCS,15853,Removal of sutures or staples,338.0,169.0,101.4,459.68,28
HCPCS,16000,First degree burn treatment,483.0,241.5,144.9,656.88,64
HCPCS,16020,"Dressing change or removal of burn tissue, less than 5% of total body surface",673.0,336.5,201.9,915.28,64
HCPCS,16025,"Dressing change or removal of burn tissue, 5-10% of total body surface",750.0,375.0,225.0,1020.0,32
HCPCS,16030,"Dressing change or removal of burn tissue, more than 10% of total body surface",935.0,467.5,280.5,1271.6,32
HCPCS,17000,"Destruction of precancer skin growth, 1 growth",485.0,242.5,145.5,659.6,32
HCPCS,17003,"Destruction of precancer skin growth, 2-14 growths",355.0,177.5,106.5,482.8,32
HCPCS,17004,"Destruction of precancer skin growth, 15 or more growths",1076.0,538.0,207.21,1463.36,32
HCPCS,17106,"Destruction of birthmark, less than 10.0 sq cm",834.0,417.0,250.2,1427.18,32
HCPCS,17110,"Destruction of skin growth, 1-14 growths",652.0,326.0,195.6,886.72,32
HCPCS,17111,"Destruction of skin growth, 15 or more growths",688.0,344.0,206.4,935.68,32
HCPCS,17250,Application of chemical to stop tissue regrowth in wound,765.0,382.5,207.21,1040.4,64
HCPCS,17260,"Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less",575.0,287.5,172.5,782.0,32
HCPCS,17261,"Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm",716.0,358.0,207.21,973.76,32
HCPCS,17262,"Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm",768.0,384.0,207.21,1044.48,32
HCPCS,17263,"Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm",806.0,403.0,207.21,1096.16,32
HCPCS,17270,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less",547.0,273.5,164.1,743.92,32
HCPCS,17271,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm",569.0,284.5,170.7,773.84,32
HCPCS,17272,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm",632.0,316.0,189.6,859.52,32
HCPCS,17273,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm",878.0,439.0,207.21,1194.08,32
HCPCS,17276,"Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm",950.0,475.0,207.21,1292.0,32
HCPCS,17281,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm",761.0,380.5,207.21,1034.96,32
HCPCS,17282,"Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm",876.0,438.0,207.21,1191.36,32
HCPCS,17311,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks",1684.0,842.0,505.2,2290.24,32
HCPCS,17312,"Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks",1324.0,662.0,397.2,1800.64,32
HCPCS,17313,"Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks",1708.0,854.0,512.4,2322.88,32
HCPCS,17314,"Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks",1238.0,619.0,371.4,1683.68,32
HCPCS,17315,"Removal and microscopic exam of growth, each additional block after 5 tissue blocks",749.0,374.5,224.7,1255.2,32
HCPCS,17999,"Other procedure on skin, mucous membrane, and tissue",2219.0,1109.5,206.4,5100.0,64
HCPCS,19000,"Aspiration of cyst of breast, first cyst",1523.0,761.5,456.9,2071.28,64
HCPCS,19001,"Aspiration of cyst of breast, each additional cyst",989.0,494.5,296.7,1345.04,32
HCPCS,19020,Drainage of abscess of breast,3605.0,1802.5,1081.5,4902.8,32
HCPCS,19081,"Biopsy of breast and placement of locating device using X-ray with needle, first growth",5495.0,2747.5,1648.5,7473.2,32
HCPCS,19082,"Biopsy of breast and placement of locating device using X-ray with needle, each additional growth",4021.0,2010.5,1206.3,5468.56,32
HCPCS,19083,"Biopsy of breast and placement of locating device using ultrasound, first growth",5153.0,2576.5,1545.9,7008.08,32
HCPCS,19084,"Biopsy of breast and placement of locating device using ultrasound, each additional growth",3767.0,1883.5,1130.1,5123.12,32
HCPCS,19085,"Biopsy of breast and placement of locating device using MRI, first growth",5877.0,2938.5,1669.7,7992.72,32
HCPCS,19086,"Biopsy of breast and placement of locating device using MRI, each additional growth",3847.0,1923.5,1154.1,5231.92,32
HCPCS,19100,Needle biopsy of breast,3254.0,1627.0,976.2,4425.44,32
HCPCS,19120,"Removal of growth and tissue of breast, duct, or nipple",6587.0,3293.5,1669.7,8958.32,32
HCPCS,19281,"Placement of locating device in breast using imaging guidance, first growth",3254.0,1627.0,976.2,4425.44,32
HCPCS,19282,"Placement of locating device in breast using imaging guidance, each additional growth",1813.0,906.5,543.9,2465.68,32
HCPCS,19283,"Placement of locating device in breast using X-ray with needle guidance, first growth",1307.0,653.5,392.1,1777.52,32
HCPCS,19284,"Placement of locating device in breast using X-ray with needle guidance, each additional growth",1090.0,545.0,327.0,1769.88,32
HCPCS,19285,"Placement of locating device in breast using ultrasound guidance, first growth",3010.0,1505.0,903.0,4093.6,32
HCPCS,19286,"Placement of locating device in breast using ultrasound guidance, each additional growth",894.0,447.0,268.2,1769.88,32
HCPCS,19287,"Placement of locating device in breast using MRI guidance, first growth",1100.0,550.0,330.0,1769.88,32
HCPCS,19288,"Placement of locating device in breast using MRI guidance, each additional growth",673.0,336.5,201.9,1769.88,32
HCPCS,20206,Needle biopsy of muscle,3438.0,1719.0,857.07,4675.68,64
HCPCS,20220,Biopsy of bone using needle or trocar,2786.0,1393.0,835.8,3788.96,32
HCPCS,20225,Deep biopsy of bone using needle or trocar,3985.0,1992.5,1195.5,5419.6,64
HCPCS,20240,Biopsy of surface bone,9269.0,4634.5,2246.0,12605.84,32
HCPCS,20500,Injection for repair of abnormal muscle drainage tract,2750.0,1375.0,825.0,3740.0,32
HCPCS,20501,Injection of abnormal muscle drainage tract for X-ray study,1056.0,528.0,316.8,1436.16,32
HCPCS,20525,Complicated removal of foreign body in deep muscle or tendon,7249.0,3624.5,2174.7,9858.64,32
HCPCS,20526,Injection of carpal tunnel,966.0,483.0,289.8,1313.76,32
HCPCS,20550,Injection into tendon or ligament,960.0,480.0,288.0,1305.6,96
HCPCS,20551,Injection into tendon at attachment to bone or muscle,979.0,489.5,293.7,1331.44,32
HCPCS,20552,"Injection of trigger points, 1-2 muscles",1034.0,517.0,308.97,1406.24,64
HCPCS,20553,"Injection of trigger points, 3 or more muscles",1222.0,611.0,308.97,1661.92,32
HCPCS,20600,Aspiration and/or injection of fluid from small joint,916.0,458.0,274.8,1245.76,64
HCPCS,20604,Aspiration and/or injection of fluid from small joint using ultrasound guidance,1169.0,584.5,350.7,1589.84,32
HCPCS,20605,Aspiration and/or injection of fluid from medium joint,1110.0,555.0,308.97,1509.6,128
HCPCS,20606,Aspiration and/or injection of fluid from medium joint using ultrasound guidance,1348.0,674.0,404.4,1833.28,96
HCPCS,20610,Aspiration and/or injection of fluid from large joint,1375.0,687.5,308.97,1870.0,160
HCPCS,20611,Aspiration and/or injection of fluid large joint using ultrasound guidance,1650.0,825.0,395.23,2244.0,96
HCPCS,20612,Aspiration and/or injection of cyst of tendon,862.0,431.0,258.6,1172.32,32
HCPCS,20650,Insertion of wire or pin to bone for traction,9598.0,4799.0,2879.4,13053.28,32
HCPCS,20670,Removal of surface implant from bone,5500.0,2750.0,1650.0,7480.0,32
HCPCS,20982,Destruction of growths and adjacent soft tissue,20119.0,10059.5,2246.0,27361.84,64
HCPCS,20983,Freezing of growth of bone and adjacent soft tissue,15000.0,7500.0,2246.0,20400.0,32
HCPCS,20999,Other procedure on muscle or bone,6380.0,3190.0,317.61,8676.8,32
HCPCS,21012,"Removal of growth under skin of face or scalp, 2.0 cm or more",3321.0,1660.5,996.3,4516.56,32
HCPCS,21013,"Removal of growth of muscle of face or scalp, less than 2.0 cm",3218.0,1609.0,965.4,4376.48,32
HCPCS,21014,"Removal of growth of muscle of face or scalp, 2.0 cm or more",4923.0,2461.5,1476.9,6695.28,32
HCPCS,21086,Impression and custom preparation of outer ear prosthesis,9557.0,4778.5,2867.1,12997.52,32
HCPCS,21235,Obtaining ear cartilage for grafting,10175.0,5087.5,3052.5,13838.0,32
HCPCS,21315,Closed treatment of broken nose bone with manipulation,3343.0,1671.5,577.3,4546.48,32
HCPCS,21320,Closed treatment of broken nose bone with placement of stabilizing device,6314.0,3157.0,577.3,8587.04,32
HCPCS,21480,Closed treatment of dislocated jaw joint,716.0,358.0,212.62,973.76,64
HCPCS,21485,Complicated repair of dislocated jaw joint with placement of stabilizing device,4522.0,2261.0,1211.37,6149.92,32
HCPCS,21550,Biopsy of soft tissue of neck or chest,3919.0,1959.5,1175.7,5329.84,32
HCPCS,21552,"Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more",4923.0,2461.5,1476.9,6695.28,32
HCPCS,21555,"Removal of growth under skin of neck or front of chest, less than 3.0 cm",4577.0,2288.5,1373.1,6224.72,32
HCPCS,21556,"Removal of growth of muscle of neck or front of chest, less than 5.0 cm",5658.0,2829.0,1697.4,7694.88,32
HCPCS,21930,"Removal of growth under skin of back or lower sides, less than 3.0 cm",4574.0,2287.0,1372.2,6220.64,32
HCPCS,21931,"Removal of growth under skin of back or lower sides, 3.0 cm or more",6610.0,3305.0,1983.0,8989.6,32
HCPCS,21932,"Removal of growth of muscle of back or lower sides, less than 5.0 cm",7821.0,3910.5,2246.0,10636.56,32
HCPCS,21933,"Removal of growth of muscle of back or lower sides, 5.0 cm or more",7920.0,3960.0,2246.0,10771.2,32
HCPCS,22510,Stabilization of upper spine bone,8077.0,4038.5,2423.1,10984.72,32
HCPCS,22511,Stabilization of lower spine bone,8199.0,4099.5,2459.7,11150.64,32
HCPCS,22512,"Stabilization of spine bone, each additional bone",6557.0,3278.5,1967.1,8917.52,32
HCPCS,22513,Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance,17500.0,8750.0,5250.0,23800.0,32
HCPCS,22514,Treatment of broken lower spine bone with placement of stabilizing device,14215.0,7107.5,4264.5,19332.4,32
HCPCS,22515,"Treatment of broken spine bone with stabilizing device, each additional segment",9371.0,4685.5,2811.3,12744.56,32
HCPCS,22902,"Removal of growth of soft tissue of abdominal wall, less than 3.0 cm",5067.0,2533.5,1520.1,6891.12,32
HCPCS,22903,"Removal of growth of soft tissue of abdominal wall, 3.0 cm or more",7082.0,3541.0,2124.6,9631.52,32
HCPCS,23350,Injection of contrast for imaging of shoulder joint,953.0,476.5,285.9,1296.08,32
HCPCS,23520,Closed treatment of dislocated joint between collar and chest bone,3575.0,1787.5,577.3,4862.0,32
HCPCS,23625,Closed treatment of upper arm bone broken at shoulder joint with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,23650,Closed treatment of dislocated shoulder with manipulation,1850.0,925.0,317.61,2516.0,64
HCPCS,23655,Closed treatment of dislocated shoulder with manipulation under anesthesia,5243.0,2621.5,1211.37,7130.48,64
HCPCS,23665,Closed treatment of dislocated shoulder and broken upper arm bone at shoulder joint with manipulation,3656.0,1828.0,577.3,4972.16,32
HCPCS,24071,"Removal of growth under skin of upper arm or elbow, 3.0 cm or more",9594.0,4797.0,2246.0,13047.84,32
HCPCS,24075,"Removal of growth under skin of upper arm or elbow, less than 3.0 cm",5547.0,2773.5,1664.1,7543.92,32
HCPCS,24076,"Removal of growth of muscle of upper arm or elbow, less than 5.0 cm",9845.0,4922.5,2246.0,13389.2,32
HCPCS,24200,"Removal of foreign body of upper arm or elbow area, accessed beneath the skin",4514.0,2257.0,1354.2,6139.04,32
HCPCS,24500,Closed treatment of broken middle part of upper arm bone,844.0,422.0,253.2,1147.84,32
HCPCS,24505,Closed treatment of broken middle part of upper arm bone with manipulation,3575.0,1787.5,577.3,4862.0,32
HCPCS,24535,Closed treatment of upper arm bone broken at elbow with manipulation,3575.0,1787.5,577.3,4862.0,32
HCPCS,24565,Closed treatment of broken outer part of upper arm bone at elbow with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,24600,Repair of dislocated elbow,938.0,469.0,281.4,1275.68,64
HCPCS,24605,Repair of dislocated elbow under anesthesia,4874.0,2437.0,1211.37,6628.64,64
HCPCS,24620,Closed treatment of broken and dislocated forearm bones at elbow with manipulation,4766.0,2383.0,577.3,6481.76,64
HCPCS,24640,"Closed treatment of dislocated forearm bone on thumb side at elbow with manipulation, child",1038.0,519.0,311.4,1411.68,64
HCPCS,24650,Closed treatment of broken forearm bone on thumb side at elbow,730.0,365.0,219.0,992.8,32
HCPCS,24999,Other procedure on upper arm or elbow,750.0,375.0,225.0,1020.0,32
HCPCS,25075,"Removal of growth under skin of forearm or wrist, less than 3.0 cm",5313.0,2656.5,1593.9,7225.68,32
HCPCS,25246,Injection of contrast for imaging of wrist,1104.0,552.0,331.2,1501.44,32
HCPCS,25260,Primary repair of tendon or muscle of palm side of forearm or wrist,9598.0,4799.0,2132.43,13053.28,32
HCPCS,25505,Closed treatment of broken midpart of forearm bone on thumb side with manipulation,3723.0,1861.5,577.3,5063.28,32
HCPCS,25520,Closed treatment of broken midpart of forearm bone on thumb side and dislocated wrist joint,4766.0,2383.0,577.3,6481.76,32
HCPCS,25530,Closed treatment of broken midpart of forearm bone on small finger side,750.0,375.0,225.0,1020.0,32
HCPCS,25565,Closed treatment of broken midpart of both forearm bones with manipulation,2761.0,1380.5,577.3,3754.96,64
HCPCS,25600,Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation,985.0,492.5,295.5,1339.6,32
HCPCS,25605,Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation,3749.0,1874.5,577.3,5098.64,64
HCPCS,25635,Closed treatment of other broken wrist bone with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,25650,Closed treatment of broken base of forearm bone on small finger side at wrist,849.0,424.5,254.7,1154.64,32
HCPCS,25660,Closed treatment of dislocated wrist bones with manipulation,763.0,381.5,228.9,1037.68,32
HCPCS,25675,Closed treatment of dislocated forearm bone at wrist with manipulation,1268.0,634.0,317.61,1724.48,64
HCPCS,25690,Closed treatment of dislocated wrist (lunate) bone with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,26010,Simple drainage of abscess of finger,837.0,418.5,207.21,1138.32,64
HCPCS,26011,Complicated drainage of abscess in finger,3013.0,1506.5,903.9,4097.68,64
HCPCS,26605,Closed treatment of broken hand bone with manipulation,1148.0,574.0,317.61,1561.28,64
HCPCS,26670,Closed treatment of dislocated hand bone at wrist joint with manipulation,874.0,437.0,262.2,1188.64,32
HCPCS,26700,Closed treatment of dislocated hand joint at base of finger with manipulation,951.0,475.5,285.3,1293.36,64
HCPCS,26705,Closed treatment of dislocated hand joint at base of finger with manipulation under anesthesia,5005.0,2502.5,1211.37,6806.8,32
HCPCS,26720,Closed treatment of broken finger or thumb at midportion or part near hand,722.0,361.0,216.6,981.92,32
HCPCS,26725,Closed treatment of broken finger or thumb at midportion or part near hand with manipulation,932.0,466.0,279.6,1267.52,64
HCPCS,26740,Closed treatment of broken finger or hand at base of finger,699.0,349.5,209.7,950.64,32
HCPCS,26742,Closed treatment of broken finger or hand at base of finger with manipulation,2752.0,1376.0,577.3,3742.72,32
HCPCS,26755,Closed treatment of broken end of finger or thumb with manipulation,825.0,412.5,247.5,1122.0,64
HCPCS,26770,Closed treatment of dislocated finger joint with manipulation,913.0,456.5,273.9,1241.68,64
HCPCS,26775,Closed treatment of dislocated finger joint with manipulation under anesthesia,980.0,490.0,294.0,1332.8,32
HCPCS,27086,"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin",8426.0,4213.0,2246.0,11459.36,32
HCPCS,27093,Injection of contrast for imaging of hip joint,1155.0,577.5,346.5,1570.8,32
HCPCS,27096,Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance,1425.0,712.5,427.5,1938.0,96
HCPCS,27238,Closed treatment of broken below neck of thigh bone,3528.0,1764.0,577.3,4798.08,32
HCPCS,27250,Closed treatment of dislocated hip,969.0,484.5,290.7,1317.84,64
HCPCS,27265,Closed treatment of dislocated hip prosthesis,1101.0,550.5,317.61,1497.36,64
HCPCS,27266,Closed treatment of dislocated hip prosthesis under anesthesia,3933.0,1966.5,1179.9,5348.88,32
HCPCS,27299,Other procedure on pelvis or hip joint,8305.0,4152.5,317.61,11294.8,32
HCPCS,27301,Drainage of deep abscess or blood accumulation of thigh or knee,8428.0,4214.0,2246.0,11462.08,32
HCPCS,27337,"Removal of growth under skin of thigh or knee, less than 3.0 cm",8148.0,4074.0,2246.0,11081.28,32
HCPCS,27502,Closed treatment of broken thigh bone at midportion with manipulation,4192.0,2096.0,577.3,5701.12,32
HCPCS,27530,Closed treatment of broken shin bone,1261.0,630.5,317.61,1714.96,32
HCPCS,27532,Closed treatment of broken shin bone with traction,5073.0,2536.5,577.3,6899.28,32
HCPCS,27550,Closed treatment of dislocated knee,866.0,433.0,259.8,1177.76,64
HCPCS,27560,Closed treatment of dislocated kneecap,891.0,445.5,267.3,1211.76,64
HCPCS,27570,Manipulation of knee joint under anesthesia,3663.0,1831.5,1098.9,4981.68,32
HCPCS,27599,Other procedure on thigh or knee,3420.5,1710.25,222.3,8296.0,64
HCPCS,27632,"Removal of growth under skin of leg or ankle, 3.0 cm or more",8950.0,4475.0,2685.0,12172.0,32
HCPCS,27752,Closed treatment of middle part of broken shin bone with manipulation,4874.0,2437.0,577.3,6628.64,64
HCPCS,27762,Closed treatment of inside portion of shin bone at ankle with manipulation,3611.0,1805.5,577.3,4910.96,64
HCPCS,27768,Closed treatment of back portion of shin bone at ankle with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,27780,Closed treatment of broken middle or upper end of outside lower leg bone,999.0,499.5,299.7,1358.64,32
HCPCS,27781,Closed treatment of broken middle or upper end of outside lower leg bone with manipulation,4666.0,2333.0,577.3,6345.76,32
HCPCS,27786,Closed treatment of broken outside lower leg bone at ankle,866.0,433.0,259.8,1177.76,32
HCPCS,27788,Closed treatment of broken outside lower leg bone at ankle with manipulation,1218.0,609.0,317.61,1656.48,64
HCPCS,27808,Closed treatment of 2 broken lower leg bones at ankle,893.0,446.5,267.9,1214.48,32
HCPCS,27810,Closed treatment of 2 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,64
HCPCS,27818,Closed treatment of 3 broken lower leg bones at ankle with manipulation,2752.0,1376.0,577.3,3742.72,64
HCPCS,27824,Closed treatment of broken shin bone at lower weight bearing joint,845.0,422.5,253.5,1149.2,32
HCPCS,27825,Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction,3131.0,1565.5,577.3,4258.16,32
HCPCS,27830,Closed treatment of dislocated knee joint,874.0,437.0,262.2,1188.64,32
HCPCS,27840,Closed treatment of dislocated ankle,1091.0,545.5,317.61,1483.76,64
HCPCS,27899,Other procedure on leg or ankle,750.0,375.0,225.0,1020.0,32
HCPCS,28190,"Removal of foreign body of foot tissue, accessed beneath the skin",2635.0,1317.5,527.72,3583.6,64
HCPCS,28289,Correction of rigid deformity of first joint of big toe,8847.0,4423.5,2654.1,12031.92,32
HCPCS,28292,Correction of bunion,8847.0,4423.5,2654.1,12031.92,32
HCPCS,28296,Correction of bunion with alignment correction of midfoot bone toward toe area,9091.0,4545.5,2727.3,12363.76,32
HCPCS,28435,Closed treatment of broken ankle joint bone with manipulation,4766.0,2383.0,577.3,6481.76,32
HCPCS,28470,Closed treatment of broken bone in forefoot or midfoot,856.0,428.0,256.8,1164.16,32
HCPCS,28490,Closed treatment of broken great toe,516.0,258.0,154.8,701.76,64
HCPCS,28495,Closed treatment of broken great toe with manipulation,605.0,302.5,181.5,822.8,64
HCPCS,28510,Closed treatment of broken toe,778.0,389.0,233.4,1058.08,64
HCPCS,28515,Closed treatment of broken toe with manipulation,850.0,425.0,255.0,1156.0,64
HCPCS,28600,Closed treatment of dislocated midfoot joint,699.0,349.5,209.7,950.64,32
HCPCS,28630,Closed treatment of dislocated joint between toe and foot,708.0,354.0,212.4,962.88,32
HCPCS,28635,Closed treatment of dislocated joint between toe and foot under anesthesia,4500.0,2250.0,1211.37,6120.0,64
HCPCS,28660,Closed treatment of dislocated joint in toe,938.0,469.0,281.4,1275.68,64
HCPCS,28665,Closed treatment of dislocated joint in toe under anesthesia,985.0,492.5,295.5,1339.6,32
HCPCS,29065,Application of shoulder to hand cast,674.0,337.0,84.1,916.64,32
HCPCS,29075,Application of elbow to finger cast,939.0,469.5,70.65,1277.04,32
HCPCS,29086,Application of finger cast,520.0,260.0,156.0,707.2,64
HCPCS,29105,Application of lower and upper arm splint,865.0,432.5,71.76,1176.4,64
HCPCS,29125,Application of nonmoveable forearm to hand splint,769.0,384.5,49.33,1045.84,64
HCPCS,29130,Application of nonmoveable finger splint,435.0,217.5,35.89,591.6,64
HCPCS,29131,Application of hinged finger splint,238.0,119.0,48.22,323.68,64
HCPCS,29240,Placement of strapping to shoulder,351.0,175.5,59.43,477.36,32
HCPCS,29260,Placement of strapping to elbow or wrist,372.0,186.0,75.96,505.92,64
HCPCS,29280,Placement of strapping to hand or finger,356.0,178.0,37.0,484.16,64
HCPCS,29345,Application of long leg cast from thigh to toe,932.0,466.0,154.75,1267.52,32
HCPCS,29405,Application of short leg cast,874.0,437.0,82.98,1188.64,64
HCPCS,29445,"Application of walking cast covering foot, ankle, and lower leg",1029.0,514.5,225.69,1399.44,32
HCPCS,29505,Application of long leg splint from thigh to ankle or toe,516.0,258.0,79.62,701.76,64
HCPCS,29515,Application of short leg splint from calf to foot,821.0,410.5,60.55,1116.56,64
HCPCS,29530,Placement of strapping to knee,441.0,220.5,47.09,599.76,64
HCPCS,29540,Placement of strapping to ankle or foot,602.0,301.0,40.37,818.72,64
HCPCS,29550,Placement of strapping to toes,374.0,187.0,38.12,508.64,64
HCPCS,29580,"Strapping, Unna boot",474.0,237.0,84.1,644.64,32
HCPCS,29581,"Application of vein wound compression bandages on lower leg, ankle, and foot",490.0,245.0,147.0,666.4,64
HCPCS,29700,"Removal or cutting of gauntlet, boot, or body cast",555.0,277.5,45.98,754.8,32
HCPCS,30000,Drainage of abscess or blood accumulation of nose,799.0,399.5,212.62,1086.64,32
HCPCS,30020,Drainage of abscess or blood accumulation of nasal cartilage,2463.0,1231.5,694.44,3349.68,64
HCPCS,30100,Biopsy of lining of nose,3284.0,1642.0,985.2,4466.24,32
HCPCS,30117,Removal or destruction of growth of nose through nose,6430.0,3215.0,1929.0,8744.8,32
HCPCS,30220,Insertion of implant to close nasal passage,2316.0,1158.0,694.8,3149.76,32
HCPCS,30300,Removal of foreign body in nose,347.0,173.5,104.1,471.92,96
HCPCS,30469,Repair of collapsed nasal valve,11727.0,5863.5,3180.04,15948.72,32
HCPCS,30802,Destruction of surface soft tissue of nasal passages,3744.0,1872.0,1123.2,5091.84,32
HCPCS,30901,Simple control of nose bleed,779.0,389.5,171.32,1059.44,96
HCPCS,30903,Complex control of nose bleed,857.0,428.5,171.32,1165.52,96
HCPCS,30905,Initial control of nose bleed and insertion of packing,863.0,431.5,171.32,1173.68,64
HCPCS,30906,Subsequent control of nosebleed and insertion of packing,755.0,377.5,212.62,1026.8,32
HCPCS,30930,Therapeutic fracture of nasal passages,9592.0,4796.0,2877.6,13045.12,32
HCPCS,31231,Diagnostic exam of nasal passages using an endoscope,1085.0,542.5,212.62,1475.6,64
HCPCS,31237,Biopsy or removal of nasal polyp or tissue using an endoscope,7700.0,3850.0,2291.78,10472.0,32
HCPCS,31238,Control of bleeding of nose using an endoscope,6964.0,3482.0,2089.2,9471.04,64
HCPCS,31242,Destruction of nasal nerve by heat using an endoscope,16757.0,8378.5,5027.1,22789.52,28
HCPCS,31243,Destruction of nasal nerve by freezing using an endoscope,16757.0,8378.5,5027.1,22789.52,28
HCPCS,31500,Emergent insertion of breathing tube into windpipe using an endoscope,920.0,460.0,276.0,1251.2,96
HCPCS,31502,Change of breathing tube in windpipe,534.0,267.0,160.2,726.24,64
HCPCS,31505,Diagnostic exam of voice box using an endoscope with mirror,685.0,342.5,205.5,931.6,64
HCPCS,31511,Removal of foreign body in voice box using an endoscope with mirror,800.0,400.0,212.62,1088.0,32
HCPCS,31535,Biopsy of voice box using an endoscope,6342.0,3171.0,1902.6,8625.12,32
HCPCS,31573,Injection of drug into side of voice box using an endoscope,4625.0,2312.5,1387.5,6290.0,32
HCPCS,31575,Diagnostic exam of voice box using a flexible endoscope,1086.0,543.0,212.62,1476.96,64
HCPCS,31576,Biopsy of voice box using a flexible endoscope,5695.0,2847.5,1708.5,7745.2,32
HCPCS,31577,Removal of foreign body in voice box using a flexible endoscope,1514.0,757.0,454.2,2059.04,32
HCPCS,31579,Exam to assess movement of vocal cord flaps using an endoscope,2446.0,1223.0,503.61,3326.56,32
HCPCS,31600,Incision of windpipe for insertion of breathing tube (older than 2 years),6516.0,3258.0,1954.8,8861.76,32
HCPCS,31605,Emergent incision of windpipe for insertion of breathing tube,2750.0,1375.0,304.97,3740.0,32
HCPCS,31615,Exam of windpipe and lung airways through permanent windpipe opening using an endoscope,2229.0,1114.5,668.7,3031.44,32
HCPCS,31622,Diagnostic exam of lung airway using an endoscope,3730.0,1865.0,1119.0,5072.8,64
HCPCS,31623,Exam of lung airways using an endoscope,3500.0,1750.0,1050.0,4760.0,64
HCPCS,31624,Irrigation and suction of lung airways to obtain cells using an endoscope,4180.0,2090.0,1254.0,5684.8,64
HCPCS,31625,Biopsy of lung airway using an endoscope,4380.0,2190.0,1314.0,5956.8,64
HCPCS,31627,Computer-assisted image-guided navigation of lung airways using an endoscope,2697.0,1348.5,809.1,3667.92,56
HCPCS,31628,"Biopsy of lobe of lung using an endoscope, 1 lobe",6143.0,3071.5,1842.9,8354.48,64
HCPCS,31629,"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope",6405.0,3202.5,1921.5,8710.8,64
HCPCS,31630,Dilation of windpipe cartilage or treatment of broken windpipe cartilage using an endoscope,6534.0,3267.0,1960.2,8886.24,64
HCPCS,31632,"Biopsy of lobe of lung using an endoscope, each additional lobe",2570.0,1285.0,771.0,3495.2,32
HCPCS,31633,"Needle biopsy of lobe of lung using an endoscope, each additional lobe",2570.0,1285.0,771.0,3495.2,64
HCPCS,31634,Exam of lung airways with repair of air leak using an endoscope,10824.0,5412.0,3247.2,14720.64,32
HCPCS,31635,Removal of foreign body in lung airways using an endoscope,4936.0,2468.0,1480.8,6712.96,32
HCPCS,31636,"Placement of stent in lung airway using an endoscope, first stent",12266.0,6133.0,3679.8,16681.76,64
HCPCS,31640,Removal of growth of lung airways using an endoscope,6295.0,3147.5,1888.5,8561.2,32
HCPCS,31641,Destruction of growth or narrowing of lung airway using an endoscope,7097.0,3548.5,2129.1,9651.92,64
HCPCS,31645,Aspiration of initial secretion of lung airway using an endoscope,4563.0,2281.5,1368.9,6205.68,32
HCPCS,31646,Aspiration of subsequent secretions of lung airway using an endoscope during same hospital stay,3652.0,1826.0,503.61,4966.72,32
HCPCS,31647,Assessment of initial lobe of lung for air leak and airway sizing with insertion of bronchial valve in lung airway using an endoscope,11041.0,5520.5,3312.3,15015.76,32
HCPCS,31648,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, initial lobe",5881.0,2940.5,1764.3,7998.16,32
HCPCS,31649,"Removal of bronchial valves of lung airways of lobe of lung using an endoscope, each additional lobe",2906.0,1453.0,871.8,4857.83,32
HCPCS,31652,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes",8250.0,4125.0,2475.0,11220.0,64
HCPCS,31653,"Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 3 or more lymph nodes",8002.0,4001.0,2400.6,10882.72,64
HCPCS,31654,Exam of lung airways with diagnostic or therapeutic procedure on growths using an endoscope and ultrasound,4685.0,2342.5,1405.5,6371.6,64
HCPCS,31820,Closure of permanent windpipe opening or abnormal drainage tract,5775.0,2887.5,1732.5,7854.0,32
HCPCS,32400,Needle biopsy of lining of lung,3183.0,1591.5,954.9,4328.88,32
HCPCS,32408,"Core needle biopsy of lung or center cavity of chest (mediastinum), accessed through skin",3709.0,1854.5,1112.7,5044.24,32
HCPCS,32550,Insertion of indwelling tube for drainage of lung fluid,7917.0,3958.5,1250.4,10767.12,64
HCPCS,32551,Removal of fluid from between lung and chest cavity,2672.0,1336.0,801.6,3633.92,96
HCPCS,32552,Removal of indwelling tube in lining of lung,1968.0,984.0,590.4,2676.48,64
HCPCS,32554,Aspiration of fluid from chest cavity,1686.0,843.0,505.8,2292.96,64
HCPCS,32555,Aspiration of fluid from chest cavity using imaging guidance,2219.0,1109.5,665.7,3017.84,128
HCPCS,32556,Drainage of fluid from chest cavity with insertion of indwelling tube,2966.0,1483.0,889.8,4033.76,64
HCPCS,32557,Drainage of fluid from chest cavity with insertion of indwelling tube using imaging guidance,3300.0,1650.0,990.0,4488.0,64
HCPCS,32994,Destruction of growth of lung using extreme cold,16279.0,8139.5,4883.7,22139.44,32
HCPCS,32999,Other procedure on lung and lung lining,3559.0,1779.5,807.71,4840.24,32
HCPCS,33016,Drainage of heart sac using imaging guidance,2948.0,1474.0,884.4,4009.28,64
HCPCS,33017,Drainage of heart sac using tube and imaging guidance (6 years or older),2985.0,1492.5,895.5,4059.6,32
HCPCS,33206,Insertion of pacemaker and upper heart chamber electrode,18000.0,9000.0,5400.0,24480.0,32
HCPCS,33207,Insertion of pacemaker and lower heart chamber electrode,18000.0,9000.0,5400.0,24480.0,32
HCPCS,33208,Insertion of pacemaker and upper and lower heart chamber electrode,20903.0,10451.5,6270.9,28428.08,32
HCPCS,33210,Insertion of temporary pacemaker lead in single heart chamber,12941.0,6470.5,1968.66,17599.76,64
HCPCS,33212,Insertion of pacemaker pulse generator with existing single lead,14235.0,7117.5,4270.5,19359.6,32
HCPCS,33215,Repositioning of pacemaker or defibrillator electrode,6654.0,3327.0,1968.66,9049.44,32
HCPCS,33216,Insertion of 1 electrode for permanent pacemaker or defibrillator,12941.0,6470.5,1968.66,17599.76,32
HCPCS,33217,Insertion of 2 electrodes for permanent pacemaker or defibrillator,12941.0,6470.5,1968.66,17599.76,32
HCPCS,33218,Repair of electrode for permanent pacemaker or defibrillator,11644.0,5822.0,1968.66,15835.84,32
HCPCS,33222,Relocation of pacemaker skin pocket,4004.0,2002.0,1201.2,5445.44,32
HCPCS,33223,Relocation of defibrillator skin pocket,4619.0,2309.5,1385.7,6281.84,32
HCPCS,33224,Insertion of left lower heart electrode and attachment to pacemaker or defibrillator,20210.0,10105.0,6063.0,27485.6,32
HCPCS,33225,Insertion of left lower heart electrode for pacemaker or defibrillator,34544.0,17272.0,9875.67,46979.84,32
HCPCS,33227,Removal and replacement of single lead permanent pacemaker,14235.0,7117.5,4270.5,19359.6,32
HCPCS,33228,Removal and replacement of dual lead permanent pacemaker,23100.0,11550.0,6930.0,31416.0,32
HCPCS,33229,Removal and replacement of multiple lead permanent pacemaker,29820.0,14910.0,8946.0,40555.2,32
HCPCS,33231,Insertion of defibrillator with existing multiple leads,50132.0,25066.0,15039.6,68179.52,32
HCPCS,33233,Removal of permanent pacemaker pulse generator,17506.0,8753.0,5251.8,23808.16,32
HCPCS,33234,Removal of single electrode from right heart,6576.0,3288.0,1968.66,8943.36,32
HCPCS,33235,Removal of dual electrodes from right heart,12096.0,6048.0,1968.66,16450.56,32
HCPCS,33240,Insertion of defibrillator with existing single lead,35098.0,17549.0,10529.4,47733.28,32
HCPCS,33241,Removal of defibrillator,6260.0,3130.0,1878.0,9612.57,32
HCPCS,33244,Removal of defibrillator electrodes through vein,11538.0,5769.0,1968.66,15691.68,32
HCPCS,33249,Insertion of implantable defibrillator system,50150.0,25075.0,15045.0,68204.0,64
HCPCS,33262,Removal and replacement of single lead defibrillator,50554.0,25277.0,15166.2,68753.44,32
HCPCS,33263,Removal and replacement of dual lead defibrillator,52572.0,26286.0,15771.6,71497.92,32
HCPCS,33264,Removal and replacement of multiple lead defibrillator,55560.0,27780.0,16668.0,75561.6,32
HCPCS,33270,Insertion or replacement of defibrillator with electrode,66823.0,33411.5,20046.9,90879.28,32
HCPCS,33272,Removal of defibrillator electrode,6576.0,3288.0,1968.66,8943.36,32
HCPCS,33273,Repositioning of defibrillator electrode,6179.0,3089.5,1853.7,8403.44,32
HCPCS,33274,Insertion of permanent leadless pacemaker using imaging guidance,44900.0,22450.0,9875.67,61064.0,32
HCPCS,33275,Removal of permanent leadless pacemaker using imaging guidance,7144.0,3572.0,2143.2,9715.84,32
HCPCS,33285,Insertion of heart rhythm monitor under skin,14235.0,7117.5,4270.5,19359.6,32
HCPCS,33286,Removal of heart rhythm monitor from under the skin,7193.0,3596.5,911.78,9782.48,32
HCPCS,33289,Insertion of wireless pressure sensor into lung artery through tube with review by radiologist,67782.0,33891.0,20334.6,92183.52,32
HCPCS,33340,Repair of left upper heart chamber with implant with review by radiologist,28500.0,14250.0,8550.0,38760.0,32
HCPCS,33361,Replacement of aortic valve through the skin and femoral artery,25731.0,12865.5,7719.3,34994.16,32
HCPCS,33367,Insertion of tube in peripheral blood vessel accessed through skin for heart-lung machine support,18250.0,9125.0,5475.0,24820.0,32
HCPCS,33418,"Repair of mitral valve through the skin, initial prosthesis",12132.0,6066.0,3639.6,19194.56,32
HCPCS,33419,"Repair of mitral valve through the skin, additional prosthesis",5500.0,2750.0,1650.0,19194.56,32
HCPCS,33477,Insertion of pulmonary valve,14244.0,7122.0,4273.2,19371.84,32
HCPCS,33745,"Creation of shunt for blood flow within heart for congenital heart defects, via catheter using imaging guidance",11673.0,5836.5,3501.9,19194.56,32
HCPCS,33881,Repair of descending aorta with insertion of graft and extensions,3125.0,1562.5,937.5,21839.3,32
HCPCS,33886,Insertion of extension after previous repair of descending aorta,1875.0,937.5,562.5,21839.3,32
HCPCS,33895,Repair of aorta by insertion of stent not crossing major side branches,4518.0,2259.0,1355.4,21839.3,32
HCPCS,33902,"Placement of stent in pulmonary artery with abnormal anatomical connections, on one side of body",53361.0,26680.5,10292.35,72570.96,32
HCPCS,33946,Initiation of ECMO external vein to vein blood circulation in heart and lungs using a pump,4200.0,2100.0,1260.0,9235.95,32
HCPCS,33947,Initiation of ECMO external vein to artery blood circulation in heart and lungs using a pump,4500.0,2250.0,1350.0,9235.95,32
HCPCS,33948,Daily management of ECMO external vein to vein blood circulation in heart and lungs using a pump,2250.0,1125.0,675.0,9235.95,32
HCPCS,33949,Daily management of ECMO external vein to artery blood circulation in heart and lungs using a pump,2250.0,1125.0,675.0,9235.95,32
HCPCS,33967,Insertion of blood flow assist device in aorta through skin,4295.0,2147.5,1288.5,10468.22,96
HCPCS,33968,Removal of blood flow assist device in aorta,2875.0,1437.5,862.5,9612.57,64
HCPCS,33990,Insertion of blood flow assist device in lower heart chamber through skin with review by radiologist using artery access,6291.0,3145.5,1887.3,39253.76,32
HCPCS,33992,Removal of blood flow assist device in left lower heart chamber through the skin,5368.0,2684.0,1610.4,9612.57,32
HCPCS,33999,Other heart surgery procedure,2310.0,1155.0,693.0,3141.6,32
HCPCS,34101,Removal of blood clot in artery of upper arm,9389.0,4694.5,2816.7,12769.04,32
HCPCS,34703,Repair of infrarenal aorta and groin artery with graft for other than rupture with review by radiologist,9629.0,4814.5,2888.7,21839.3,32
HCPCS,34705,Repair of infrarenal aorta and groin artery with graft for other than rupture on both sides with review by radiologist,10110.0,5055.0,3033.0,21839.3,32
HCPCS,34709,Repair of abdominal or groin artery with prosthesis with review by radiologist,8124.0,4062.0,2437.2,21839.3,32
HCPCS,34710,"Delayed insertion of prosthesis for repair of abdominal or groin artery with review by radiologist, initial vessel treated",5800.0,2900.0,1740.0,21839.3,32
HCPCS,34713,Exposure of groin artery for delivery of graft,459.0,229.5,137.7,21839.3,32
HCPCS,36002,Injection to cause blood clot in diseased or pseudoaneurysm of arm or leg,1293.0,646.5,387.9,1758.48,32
HCPCS,36005,Injection for X-ray imaging procedure into vein of arm or leg,843.0,421.5,252.9,1146.48,32
HCPCS,36010,Insertion of tube into vena cava,2725.0,1362.5,817.5,3706.0,32
HCPCS,36011,"Insertion of tube into vein, first order branch",2265.0,1132.5,679.5,3080.4,64
HCPCS,36012,"Insertion of tube into vein, second order branch",2750.0,1375.0,825.0,3740.0,64
HCPCS,36013,Insertion of tube into right heart or main pulmonary artery,1018.0,509.0,305.4,1384.48,32
HCPCS,36014,Insertion of tube into left or right pulmonary artery,2966.0,1483.0,858.24,4033.76,32
HCPCS,36015,Insertion of tube into artery of lobe of lung,2243.0,1121.5,672.9,3050.48,32
HCPCS,36140,Insertion of needle or tube into artery of arm or leg,1956.0,978.0,586.8,2660.16,32
HCPCS,36200,Insertion of tube into aorta,2063.0,1031.5,618.9,2805.68,64
HCPCS,36215,"Insertion of tube into chest or arm artery, each first order branch",2091.0,1045.5,627.3,2843.76,64
HCPCS,36216,"Insertion of tube into chest or arm artery, initial second order branch",2605.0,1302.5,781.5,3542.8,32
HCPCS,36217,"Insertion of tube into chest or arm artery, initial third order branch",3562.0,1781.0,858.24,4844.32,64
HCPCS,36218,"Insertion of tube into chest or arm artery, additional second, third order and beyond",1513.0,756.5,453.9,2057.68,64
HCPCS,36221,Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist,9978.0,4989.0,2993.4,13570.08,32
HCPCS,36222,Insertion of tube into extracranial artery for diagnosis or treatment with review by radiologist,15718.5,7859.25,3143.7,28502.88,96
HCPCS,36223,Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist,12979.0,6489.5,3114.9,21182.0,96
HCPCS,36224,Insertion of tube into internal neck artery for diagnosis or treatment with review by radiologist,25132.5,12566.25,5547.53,41016.24,64
HCPCS,36225,Insertion of tube into chest artery for diagnosis or treatment with review by radiologist,11064.0,5532.0,3319.2,15047.04,32
HCPCS,36226,Insertion of tube into brain artery for diagnosis or treatment with review by radiologist,18911.5,9455.75,4538.7,30863.84,128
HCPCS,36227,Insertion of tube into external neck artery for diagnosis or treatment with review by radiologist,21170.0,10585.0,5080.8,34549.44,96
HCPCS,36228,Insertion of tube into neck or brain artery for diagnosis or treatment with review by radiologist,6625.0,3312.5,1987.5,9010.0,32
HCPCS,36245,"Insertion of tube into abdominal, pelvic, or leg artery, each first order branch",3199.0,1599.5,858.24,4350.64,64
HCPCS,36246,"Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch",3541.0,1770.5,858.24,4815.76,64
HCPCS,36247,"Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch",4355.0,2177.5,858.24,5922.8,64
HCPCS,36248,"Insertion of tube into abdominal, pelvic, or leg artery, additional second, third, and beyond",1513.0,756.5,453.9,2057.68,32
HCPCS,36251,Insertion of tube into first order main and accessory arteries of kidney for imaging with review by radiologist,7332.0,3666.0,2199.6,9971.52,32
HCPCS,36252,Insertion of tube into first order main and accessory arteries of both kidneys for imaging with review by radiologist,8064.0,4032.0,2419.2,10967.04,32
HCPCS,36253,Insertion of tube into second or third order branches of arteries of kidney for imaging with review by radiologist,9439.0,4719.5,2831.7,12837.04,32
HCPCS,36299,Other blood vessel injection procedure,1650.0,825.0,495.0,2244.0,32
HCPCS,36406,Insertion of needle into vein (younger than 3 years),150.0,75.0,3.43,204.0,32
HCPCS,36410,Insertion of needle into vein (3 years or older),172.0,86.0,10.99,233.92,64
HCPCS,36415,Insertion of needle into vein for collection of blood sample,32.0,16.0,3.41,43.52,32
HCPCS,36416,Puncture of skin for collection of blood sample,31.0,15.5,3.26,42.16,64
HCPCS,36430,Transfusion of blood or blood products,1304.0,652.0,391.2,1773.44,128
HCPCS,36466,Injection of chemical agent into multiple incompetent veins of same leg using ultrasound guidance,5407.0,2703.5,797.04,7353.52,32
HCPCS,36468,"Injection of chemical agent into spider vein of arm, leg, or trunk",1182.0,591.0,354.6,1607.52,32
HCPCS,36470,Injection of chemical agent into single incompetent vein,625.0,312.5,187.5,850.0,32
HCPCS,36471,Injection of chemical agent into multiple incompetent veins of leg,688.0,344.0,206.4,935.68,32
HCPCS,36478,Laser destruction of incompetent vein of arm or leg using imaging guidance,5360.0,2680.0,1608.0,7289.6,32
HCPCS,36481,Insertion of tube into portal vein of liver,2426.0,1213.0,727.8,3299.36,32
HCPCS,36482,Chemical destruction of first incompetent vein of arm or leg using imaging guidance,13443.0,6721.5,3413.75,18282.48,32
HCPCS,36500,Insertion of tube into vein with collection of blood sample,1018.0,509.0,305.4,1384.48,32
HCPCS,36510,"Insertion of tube into umbilical vein, newborn",802.0,401.0,94.28,1090.72,32
HCPCS,36511,Mechanical separation of white blood cells from blood,4252.0,2126.0,1275.6,5782.72,32
HCPCS,36512,Mechanical separation of red blood cells from blood,4883.0,2441.5,1464.9,6640.88,64
HCPCS,36514,Mechanical separation of plasma from blood,6197.0,3098.5,1859.1,8427.92,64
HCPCS,36522,Mechanical separation of white blood cells and platelets from blood,12376.0,6188.0,3712.8,16831.36,32
HCPCS,36555,Insertion of non-tunneled central venous tube for infusion (younger than 5 years),4922.0,2461.0,1377.13,6693.92,96
HCPCS,36556,Insertion of non-tunneled central venous tube for infusion (5 years or older),4922.0,2461.0,1377.13,6693.92,96
HCPCS,36557,Insertion of tunneled central venous tube for infusion (younger than 5 years),8453.0,4226.5,2535.9,11496.08,32
HCPCS,36558,Insertion of tunneled central venous tube for infusion (5 years or older),6262.0,3131.0,1878.6,8516.32,32
HCPCS,36561,Insertion of central venous tube with port (5 years or older),11266.0,5633.0,2659.52,15321.76,32
HCPCS,36568,Insertion of tube for infusion (younger than 5 years),2429.0,1214.5,728.7,3303.44,32
HCPCS,36569,Insertion of tube for infusion (5 years or older),2726.0,1363.0,817.8,3707.36,32
HCPCS,36572,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient younger than 5 years",2468.0,1234.0,740.4,3356.48,64
HCPCS,36573,"Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older",4302.0,2151.0,1290.6,5850.72,64
HCPCS,36575,Repair of central venous tube for infusion,1706.0,853.0,511.8,2320.16,32
HCPCS,36576,Repair of central venous tube for infusion with port or pump,2429.0,1214.5,728.7,3303.44,32
HCPCS,36580,Replacement of nontunneled central venous tube,3724.0,1862.0,1117.2,5064.64,32
HCPCS,36581,Replacement of tunneled central venous tube,5619.0,2809.5,1685.7,7641.84,64
HCPCS,36582,Replacement of tunneled central venous tube with port,6387.0,3193.5,1916.1,8686.32,32
HCPCS,36584,Replacement of peripherally inserted central venous tube (PICC) with review by radiologist,3172.0,1586.0,951.6,4313.92,64
HCPCS,36589,Removal of tunneled central venous tube,2874.0,1437.0,807.71,3908.64,64
HCPCS,36590,Removal of central venous tube with port or pump,3521.0,1760.5,925.11,4788.56,32
HCPCS,36591,Collection of blood sample from implanted device,402.0,201.0,94.28,546.72,64
HCPCS,36592,Collection of blood sample from central venous tube,412.0,206.0,94.28,560.32,64
HCPCS,36593,Declotting of central venous tube,1032.0,516.0,309.6,1403.52,96
HCPCS,36595,Mechanical removal of obstructive material from central venous tube,4922.0,2461.0,925.11,6693.92,32
HCPCS,36597,Repositioning of central venous tube using fluoroscopic guidance,2429.0,1214.5,728.7,3303.44,32
HCPCS,36598,Contrast injection for imaging to evaluate central venous access device,1302.0,651.0,273.88,1770.72,32
HCPCS,36600,Artery puncture collection of blood sample,150.0,75.0,45.0,204.0,64
HCPCS,36620,Insertion of artery tube for blood sampling or infusion through skin,938.0,469.0,281.4,1275.68,64
HCPCS,36680,Insertion of needle for infusion into bone,861.0,430.5,258.3,1170.96,96
HCPCS,36836,Creation of opening between artery and vein in arm with single access to both blood vessels,54252.0,27126.0,4416.11,73782.72,32
HCPCS,36901,Insertion of needle and/or tube into hemodialysis circuit with review by radiologist,4620.0,2310.0,1386.0,6283.2,32
HCPCS,36902,Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,21509.0,10754.5,4624.13,29252.24,32
HCPCS,36903,Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist,33726.0,16863.0,10117.8,45867.36,32
HCPCS,36904,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist,9807.0,4903.5,2942.1,13337.52,32
HCPCS,36905,"Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube",27071.0,13535.5,7754.24,36816.56,32
HCPCS,36906,Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist,43835.0,21917.5,13150.5,59615.6,32
HCPCS,36907,Balloon dilation of dialysis segment with review by radiologist,11930.0,5965.0,3579.0,16224.8,32
HCPCS,36908,Insertion of stent in dialysis segment with review by radiologist,19043.0,9521.5,5712.9,25898.48,32
HCPCS,36909,Permanent blockage of hemodialysis circuit with review by radiologist,17146.0,8573.0,5143.8,23318.56,32
HCPCS,37182,Insertion of shunts to bypass blood flow to liver with review by radiologist,9195.0,4597.5,2758.5,23603.71,32
HCPCS,37183,Revision of shunts to bypass blood flow to liver with review by radiologist,13401.0,6700.5,4020.3,18225.36,32
HCPCS,37184,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, initial vessel",28078.0,14039.0,7754.24,38186.08,32
HCPCS,37185,"Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance, subsequent vessels",5276.0,2638.0,1582.8,8219.5,32
HCPCS,37186,Secondary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance,7223.0,3611.5,2166.9,14230.97,32
HCPCS,37187,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment",17732.0,8866.0,4624.13,24115.52,64
HCPCS,37188,"Removal and dissolving of blood clot from vein using fluoroscopic guidance, repeat treatment on subsequent day",6636.0,3318.0,1990.8,9024.96,32
HCPCS,37191,Insertion of vena cava filter with review by radiologist,10590.0,5295.0,3177.0,14402.4,32
HCPCS,37193,Removal of vena cava filter with review by radiologist,10112.0,5056.0,3033.6,13752.32,32
HCPCS,37197,Retrieval of foreign body in blood vessel with review by radiologist,6012.0,3006.0,1803.6,8176.32,32
HCPCS,37200,Biopsy of blood vessel using tube,8453.0,4226.5,2535.9,11496.08,32
HCPCS,37211,"Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial treatment day",8500.0,4250.0,2550.0,11560.0,32
HCPCS,37212,"Insertion of tube into vein for drug infusion for blood clot with review by radiologist, initial treatment day",5264.0,2632.0,1579.2,7159.04,64
HCPCS,37213,Insertion of tube into artery or vein for drug infusion for blood clot with review by radiologist,5001.0,2500.5,1500.3,6801.36,32
HCPCS,37214,Removal of tube into artery or vein with review by radiologist,6039.0,3019.5,1811.7,8213.04,32
HCPCS,37215,Insertion of stent and blood clot protection device in neck artery with review by radiologist,7737.0,3868.5,2321.1,18704.53,64
HCPCS,37216,Insertion of stent in neck artery with review by radiologist,16772.0,8386.0,5031.6,22809.92,32
HCPCS,37236,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, initial artery",17732.0,8866.0,5319.6,24115.52,32
HCPCS,37237,"Insertion of stent in artery (except lower extremity, chest, heart, neck and brain) with review by radiologist, each additional artery",13369.0,6684.5,4010.7,18181.84,32
HCPCS,37238,"Insertion of stent in vein with review by radiologist, initial vein",18833.0,9416.5,5649.9,25612.88,64
HCPCS,37239,"Insertion of stent in vein with review by radiologist, each additional vein",13494.0,6747.0,4048.2,18351.84,32
HCPCS,37241,Occlusion of vein with review by radiologist,23982.0,11991.0,7194.6,32615.52,32
HCPCS,37242,Occlusion of artery with review by radiologist,28078.0,14039.0,8423.4,38186.08,64
HCPCS,37243,Occlusion of growths or obstructed vessels with review by radiologist,22844.0,11422.0,6853.2,31067.84,64
HCPCS,37244,Occlusion of artery or vein bleeding with review by radiologist,34178.0,17089.0,10253.4,46482.08,32
HCPCS,37246,"Balloon dilation of artery with review by radiologist, initial artery",10467.0,5233.5,3140.1,14235.12,64
HCPCS,37247,"Balloon dilation of artery with review by radiologist, each additional artery",10081.0,5040.5,3024.3,13710.16,32
HCPCS,37248,"Balloon dilation of vein with review by radiologist, initial vein",9807.0,4903.5,2942.1,13337.52,32
HCPCS,37249,"Balloon dilation of vein with review by radiologist, each additional vein",7992.0,3996.0,2397.6,10869.12,32
HCPCS,37252,"Ultrasound evaluation of blood vessel with review by radiologist, initial vessel",4297.0,2148.5,1289.1,5843.92,28
HCPCS,37253,"Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel",3009.0,1504.5,902.7,4092.24,28
HCPCS,37609,Tying or biopsy of artery on side of skull,6144.0,3072.0,1843.2,8355.84,32
HCPCS,37799,Other procedure on blood vessel,9691.0,4845.5,495.0,24115.52,64
HCPCS,38205,Collection of donor stem cells for transplantation,4725.0,2362.5,1417.5,6426.0,30
HCPCS,38206,Collection of stem cells for transplantation,7051.0,3525.5,2005.33,9589.36,30
HCPCS,38207,Preservation and storage of stem cells for transplantation,4650.0,2325.0,568.05,6324.0,32
HCPCS,38208,Thawing of frozen stem cells for transplantation,1287.0,643.5,386.1,2175.73,32
HCPCS,38214,Preparation of stem cells for transplantation with reduction of blood fluid (plasma) volume,1286.0,643.0,385.8,2175.73,32
HCPCS,38215,Preparation of stem cells for transplantation with cell concentration in blood fluid (plasma),3674.0,1837.0,568.05,4996.64,32
HCPCS,38220,Aspiration of bone marrow sample for diagnosis,2533.0,1266.5,759.9,3444.88,32
HCPCS,38221,Biopsy of bone marrow,2609.0,1304.5,782.7,3548.24,32
HCPCS,38222,Biopsy and aspiration of bone marrow sample for diagnosis,4589.0,2294.5,1376.7,6241.04,32
HCPCS,38225,"Harvesting of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy, per day",3500.0,1750.0,1050.0,4760.0,26
HCPCS,38226,Preparation of blood-derived T white blood cells (T lymphocytes) for transportation for chimeric antigen receptor T-cell (CAR-T) therapy,1800.0,900.0,540.0,2448.0,26
HCPCS,38227,Receipt and preparation of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,1129.0,564.5,338.7,1535.44,26
HCPCS,38228,Administration of blood-derived T white blood cells (T lymphocytes) for chimeric antigen receptor T-cell (CAR-T) therapy,5809.0,2904.5,425.3,7900.24,26
HCPCS,38240,Transplantation of donor stem cells per donor,92477.0,46238.5,5568.9,125768.72,32
HCPCS,38241,Transplantation of patient-derived stem cells,6160.0,3080.0,1848.0,8377.6,32
HCPCS,38505,Needle biopsy or removal of surface lymph nodes,2786.0,1393.0,835.8,3788.96,32
HCPCS,38790,Injection procedure for imaging of lymphatic system,1875.0,937.5,411.09,2550.0,32
HCPCS,38792,Injection of radioactive material for X-ray identification of lymph node,1203.0,601.5,360.9,1636.08,32
HCPCS,38794,Exposure of lymph duct of chest cavity,1283.0,641.5,384.9,1744.88,32
HCPCS,40490,Biopsy of lip,878.0,439.0,212.62,1194.08,64
HCPCS,40650,Repair of lip and border,1868.0,934.0,212.62,2540.48,64
HCPCS,40652,Repair of vertical lip wound extending to half of lip,1563.0,781.5,212.62,2125.68,64
HCPCS,40654,Repair of vertical lip wound extending to over half of lip,4359.0,2179.5,1307.7,5928.24,32
HCPCS,40800,"Simple drainage of abscess, cyst, or blood accumulation of mouth",1100.0,550.0,330.0,1591.79,64
HCPCS,40804,Simple removal of embedded foreign body in mouth,1900.0,950.0,570.0,2584.0,32
HCPCS,40808,Biopsy of mouth,1315.0,657.5,394.5,1788.4,32
HCPCS,40810,Removal of growth of tissue of mouth,4813.0,2406.5,1443.9,6545.68,32
HCPCS,40812,Removal of growth of mouth with simple repair,4267.0,2133.5,1280.1,5803.12,32
HCPCS,40820,Destruction of growth or scar of mouth,4377.0,2188.5,1313.1,5952.72,32
HCPCS,40830,"Repair of lacerated mouth, 2.5 cm or less",761.0,380.5,212.62,1034.96,64
HCPCS,40831,"Repair of lacerated mouth, more than 2.5 cm",1521.0,760.5,456.3,2068.56,32
HCPCS,41008,"Drainage of abscess, cyst, or blood accumulation under jaw bone from inside mouth",6694.0,3347.0,1755.59,9103.84,32
HCPCS,41010,Incision of tissue connecting tongue and floor of mouth,2656.0,1328.0,796.8,3612.16,32
HCPCS,41100,Biopsy of front 2/3 of tongue,2443.0,1221.5,212.62,3322.48,64
HCPCS,41105,Biopsy of back 1/3 of tongue,5520.0,2760.0,1656.0,7507.2,32
HCPCS,41108,Biopsy of floor of mouth,2533.0,1266.5,759.9,3444.88,32
HCPCS,41110,Removal of growth of tongue without closure,5578.0,2789.0,1673.4,7586.08,32
HCPCS,41112,Removal of growth of front 2/3 of tongue with switches,6563.0,3281.5,1755.59,8925.68,32
HCPCS,41250,"Repair of lacerated floor of mouth and/or tongue, 2.5 cm or less",1531.0,765.5,212.62,2082.16,64
HCPCS,41251,"Repair of lacerated back 1/3 of tongue, 2.5 cm or less",898.0,449.0,212.62,1221.28,32
HCPCS,41252,"Repair of lacerated tongue or floor of mouth, more than 2.6 cm",1211.0,605.5,212.62,1646.96,64
HCPCS,41800,"Drainage of abscess, cyst, or blood accumulation of dental bone",605.0,302.5,171.32,822.8,64
HCPCS,41899,Other procedure on teeth and gums,800.0,400.0,240.0,1591.79,32
HCPCS,42000,Drainage of abscess of roof of mouth,734.0,367.0,212.62,998.24,32
HCPCS,42100,Biopsy of roof of mouth,2782.0,1391.0,834.6,3783.52,32
HCPCS,42104,Removal of growth of roof of mouth,5578.0,2789.0,1673.4,7586.08,32
HCPCS,42140,Removal of soft tissue of roof of mouth,9729.0,4864.5,2918.7,13231.44,32
HCPCS,42400,Needle biopsy of saliva gland,2001.0,1000.5,600.3,2721.36,32
HCPCS,42405,Biopsy of saliva gland,5304.0,2652.0,1591.2,7213.44,32
HCPCS,42660,Dilation of saliva gland duct and insertion of tube,2288.0,1144.0,686.4,3111.68,32
HCPCS,42700,Drainage of abscess near tonsil,1244.0,622.0,212.62,1691.84,96
HCPCS,42800,Biopsy of back of throat,6226.0,3113.0,1755.59,8467.36,32
HCPCS,42809,Removal of foreign body in throat,830.0,415.0,212.62,1128.8,64
HCPCS,42955,Creation of opening to throat for feeding,4225.0,2112.5,1267.5,5746.0,32
HCPCS,42999,"Other procedure on throat, adenoids, or tonsils",622.0,311.0,186.6,2640.53,32
HCPCS,43180,Removal of defect in wall of esophagus using a rigid endoscope,10175.0,5087.5,3052.5,13838.0,32
HCPCS,43200,Diagnostic exam of esophagus using a flexible endoscope through mouth,2569.0,1284.5,770.7,3493.84,32
HCPCS,43202,Biopsy of esophagus using a flexible endoscope through mouth,3410.0,1705.0,1023.0,4637.6,32
HCPCS,43205,Tying of dilated veins of esophagus with bands using a flexible endoscope,3716.0,1858.0,1114.8,5053.76,32
HCPCS,43210,Repair of muscle at esophagus and stomach using a flexible endoscope,15196.0,7598.0,4558.8,20666.56,32
HCPCS,43212,Placement of stent in esophagus using a flexible endoscope,7841.0,3920.5,2352.3,10663.76,32
HCPCS,43215,Removal of foreign bodies in esophagus using a flexible endoscope,3761.0,1880.5,1128.3,5114.96,32
HCPCS,43220,"Balloon dilation of esophagus using a flexible endoscope, less than 3.0 cm",4802.0,2401.0,1210.47,6530.72,32
HCPCS,43226,Dilation of esophagus with insertion of guide wire using a flexible endoscope,9635.0,4817.5,1210.47,13103.6,32
HCPCS,43227,Control of bleeding in esophagus using a flexible endoscope,7027.0,3513.5,1210.47,9556.72,32
HCPCS,43229,Destruction of polyp or growth of esophagus using a flexible endoscope,7500.0,3750.0,2250.0,10200.0,32
HCPCS,43231,Ultrasound exam of esophagus using a flexible endoscope,8175.0,4087.5,1210.47,11118.0,32
HCPCS,43232,Ultrasound guided fine needle aspiration or biopsy of esophagus using a flexible endoscope,8995.0,4497.5,1210.47,12233.2,32
HCPCS,43233,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more",6461.0,3230.5,1210.47,8786.96,32
HCPCS,43235,"Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",4228.0,2114.0,1167.83,5750.08,32
HCPCS,43236,"Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5190.0,2595.0,1167.83,7058.4,32
HCPCS,43237,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope through mouth",6695.0,3347.5,1210.47,9105.2,32
HCPCS,43238,Ultrasound guided needle aspiration or biopsy of esophagus using a flexible endoscope,6058.0,3029.0,1210.47,8238.88,32
HCPCS,43239,"Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",4749.0,2374.5,1167.83,6458.64,32
HCPCS,43240,"Drainage of fluid collection of esophagus, stomach, and/or upper small bowel using a flexible endoscope",9308.0,4654.0,2792.4,12658.88,32
HCPCS,43241,"Insertion of tube or tube in esophagus, stomach, and/or upper small bowel using a flexible endoscope",4900.0,2450.0,1210.47,6664.0,32
HCPCS,43242,"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7985.0,3992.5,1210.47,10859.6,32
HCPCS,43243,Injection of dilated vein of stomach and/or esophagus using a flexible endoscope,4641.0,2320.5,1210.47,6311.76,32
HCPCS,43244,Tying of dilated veins of stomach and/or esophagus using a flexible endoscope,5370.0,2685.0,1210.47,7303.2,32
HCPCS,43245,Dilation of stomach outlet using a flexible endoscope,6070.0,3035.0,1210.47,8255.2,32
HCPCS,43246,Insertion of stomach tube using a flexible endoscope,6432.0,3216.0,1210.47,8747.52,32
HCPCS,43247,"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope",6058.0,3029.0,1167.83,8238.88,32
HCPCS,43248,Insertion of guide wire with dilation of esophagus using a flexible endoscope,5699.0,2849.5,1167.83,7750.64,32
HCPCS,43249,"Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm",5271.0,2635.5,1210.47,7168.56,32
HCPCS,43251,"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare",5861.0,2930.5,1210.47,7970.96,32
HCPCS,43253,"Injection of diagnostic or therapeutic substance or marker in esophagus, stomach, and/or upper small bowel using a flexible endoscope",5262.0,2631.0,1210.47,7156.32,32
HCPCS,43254,"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5381.0,2690.5,1614.3,7318.16,32
HCPCS,43255,"Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope",5788.0,2894.0,1210.47,7871.68,32
HCPCS,43259,"Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7749.0,3874.5,1210.47,10538.64,32
HCPCS,43260,"Diagnostic exam of gallbladder and pancreatic, liver, and bile ducts using an endoscope",7889.0,3944.5,2366.7,10729.04,32
HCPCS,43261,"Biopsy of gallbladder, pancreatic, liver, and bile ducts using a flexible endoscope",8819.0,4409.5,2645.7,11993.84,32
HCPCS,43262,Incision of pancreatic outlet using a flexible endoscope,8727.0,4363.5,2618.1,11868.72,32
HCPCS,43264,Removal of stone or debris from bile or pancreatic duct using a flexible endoscope,8909.0,4454.5,2672.7,12116.24,32
HCPCS,43265,Destruction of stone of bile or pancreatic duct using a flexible endoscope,10560.0,5280.0,3168.0,14361.6,32
HCPCS,43266,"Placement of stent in esophagus, stomach, and/or upper small bowel using a flexible endoscope",11723.0,5861.5,3516.9,15943.28,32
HCPCS,43270,"Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope",7703.0,3851.5,2310.9,10476.08,32
HCPCS,43273,Exam of common bile and/or pancreatic duct using a flexible endoscope,3890.0,1945.0,1167.0,5667.91,32
HCPCS,43274,Insertion of stent into pancreatic or bile duct using a flexible endoscope,10216.0,5108.0,3064.8,13893.76,32
HCPCS,43275,Removal of stent from pancreatic or bile duct using a flexible endoscope,9200.0,4600.0,2470.77,12512.0,32
HCPCS,43276,Replacement of stent in pancreatic or bile duct using a flexible endoscope,11755.0,5877.5,3526.5,15986.8,32
HCPCS,43277,Balloon dilation of pancreatic or bile duct or sphincter using a flexible endoscope,9249.0,4624.5,2774.7,12578.64,32
HCPCS,43278,Destruction of polyp or growth of gallbladder and/or bile duct using a flexible endoscope,10577.0,5288.5,3173.1,14384.72,32
HCPCS,43497,Incision of muscle of lower esophagus using an endoscope,10730.0,5365.0,3219.0,14592.8,32
HCPCS,43752,Insertion of stomach tube through nose or mouth using fluoroscopic guidance,778.0,389.0,233.4,1058.08,32
HCPCS,43753,Insertion of stomach tube and aspiration of stomach contents,688.0,344.0,206.4,935.68,56
HCPCS,43761,Repositioning of oral or nasal feeding tube in small bowel,1975.0,987.5,321.7,2686.0,64
HCPCS,43762,Replacement of stomach stoma tube,1184.0,592.0,321.7,1610.24,64
HCPCS,43763,Replacement of stomach stoma tube with revision of stoma opening,1088.0,544.0,321.7,1479.68,32
HCPCS,43999,Other procedure on stomach,4180.0,2090.0,1167.83,5684.8,32
HCPCS,44360,Diagnostic exam of small bowel (excluding lower small intestine) using an endoscope,4935.0,2467.5,1210.47,6711.6,32
HCPCS,44361,Biopsy of small bowel (except ileum) using an endoscope,5458.0,2729.0,1210.47,7422.88,32
HCPCS,44363,Removal of foreign bodies from small bowel using an endoscope,6572.0,3286.0,1971.6,8937.92,32
HCPCS,44364,Removal of small bowel polyps or growths using an endoscope with mechanical snare,7715.0,3857.5,2314.5,10492.4,32
HCPCS,44366,Control of bleeding of first or second part of small bowel using an endoscope,8221.0,4110.5,2466.3,11180.56,32
HCPCS,44369,Destruction of polyp or growth of small bowel using an endoscope,8419.0,4209.5,1210.47,11449.84,32
HCPCS,44370,Insertion of small bowel stent above lower small bowel using an endoscope,18616.0,9308.0,2516.76,25317.76,32
HCPCS,44372,Insertion of tube into middle small bowel using an endoscope,4566.0,2283.0,1210.47,6209.76,32
HCPCS,44373,Conversion of stomach tube to tube in middle small bowel using an endoscope,6619.0,3309.5,1210.47,9001.84,32
HCPCS,44377,Biopsy of small bowel using an endoscope,6634.0,3317.0,1210.47,9022.24,32
HCPCS,44378,Control of bleeding of small bowel using an endoscope,8541.0,4270.5,2470.77,11615.76,32
HCPCS,44380,Diagnostic exam of small bowel using an endoscope inserted through surgically created opening from small bowel to skin,4189.0,2094.5,1167.83,5697.04,32
HCPCS,44381,Balloon dilation of small bowel using an endoscope,3998.0,1999.0,1199.4,5437.28,32
HCPCS,44382,Biopsy of small bowel using an endoscope inserted through surgically created opening from lower small bowel to skin,4178.0,2089.0,1167.83,5682.08,32
HCPCS,44385,Diagnostic exam of surgically created pouch of small bowel using an endoscope,2979.0,1489.5,893.7,4051.44,32
HCPCS,44386,Biopsy of small bowel pouch using an endoscope,4635.0,2317.5,1197.41,6303.6,32
HCPCS,44388,Diagnostic exam of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3312.0,1656.0,993.6,4504.32,32
HCPCS,44389,Biopsy of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3565.0,1782.5,1069.5,4848.4,32
HCPCS,44394,Removal of growths or polyps of large bowel by mechanical snare using an endoscope inserted through surgically created opening into large bowel to skin,4662.0,2331.0,1236.88,6340.32,32
HCPCS,44401,Destruction of growth or polyp of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,4997.0,2498.5,1236.88,6795.92,32
HCPCS,44404,Injection beneath lining of large bowel using an endoscope inserted through surgically created opening from large bowel to skin,3565.0,1782.5,1069.5,4848.4,32
HCPCS,44500,Dilation of stomach and/or small bowel using long gastrointestinal tube,1466.0,733.0,439.8,1993.76,32
HCPCS,44799,Other procedure on small bowel,5205.0,2602.5,1167.83,7078.8,32
HCPCS,45100,Biopsy of anal and/or rectal wall through anus,7599.0,3799.5,1805.07,10334.64,32
HCPCS,45300,Diagnostic exam of rectum and lower large bowel using an endoscope,5743.0,2871.5,1197.41,7810.48,32
HCPCS,45330,Diagnostic exam of lower portion of large bowel using a flexible endoscope,4433.0,2216.5,1197.41,6028.88,32
HCPCS,45331,Biopsy of lower large bowel using a flexible endoscope,4567.0,2283.5,1197.41,6211.12,32
HCPCS,45332,Removal of foreign bodies in lower portion of large bowel using a flexible endoscope,5227.0,2613.5,1236.88,7108.72,32
HCPCS,45334,Control of bleeding of lower large bowel using a flexible endoscope,4848.0,2424.0,1236.88,6593.28,32
HCPCS,45335,Injection beneath lining of lower large bowel using a flexible endoscope,4522.0,2261.0,1197.41,6149.92,32
HCPCS,45337,Decompression of twisted or abnormally dilated lower large bowel using a flexible endoscope,4800.0,2400.0,1197.41,6528.0,32
HCPCS,45338,Removal of polyps or growths of lower large bowel using a flexible endoscope with mechanical snare,4896.0,2448.0,1236.88,6658.56,32
HCPCS,45340,Balloon dilation of lower large bowel using a flexible endoscope,4613.0,2306.5,1236.88,6273.68,32
HCPCS,45341,Ultrasound exam of lower large bowel using a flexible endoscope,4945.0,2472.5,1197.41,6725.2,32
HCPCS,45342,Fine needle aspiration and/or biopsy of lower large bowel with ultrasound guidance using a flexible endoscope,5217.0,2608.5,1236.88,7095.12,32
HCPCS,45346,Destruction of polyp or growth of lower large bowel using a flexible endoscope,5045.0,2522.5,1236.88,6861.2,32
HCPCS,45347,Insertion of stent into lower large bowel using a flexible endoscope,6575.0,3287.5,1972.5,8942.0,32
HCPCS,45349,Removal of lower portion of large bowel tissue using a flexible endoscope,5146.0,2573.0,1543.8,6998.56,32
HCPCS,45350,Banding of hemorrhoids using a flexible endoscope (sigmoidoscope),4705.0,2352.5,1236.88,6398.8,32
HCPCS,45378,Diagnostic exam of large bowel using a flexible endoscope,4777.0,2388.5,1197.41,6496.72,32
HCPCS,45379,Removal of foreign bodies in large bowel using a flexible endoscope,5538.0,2769.0,1236.88,7531.68,32
HCPCS,45380,Biopsy of large bowel using a flexible endoscope,4991.0,2495.5,1236.88,6787.76,32
HCPCS,45381,Injection beneath lining of large bowel using a flexible endoscope,4920.0,2460.0,1236.88,6691.2,32
HCPCS,45382,Control of bleeding of upper large bowel using a flexible endoscope,6023.0,3011.5,1236.88,8191.28,32
HCPCS,45384,Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery,5220.0,2610.0,1236.88,7099.2,32
HCPCS,45385,Removal of polyps or growths of large bowel using an endoscope with mechanical snare,5848.0,2924.0,1236.88,7953.28,32
HCPCS,45386,Balloon dilation of large bowel using a flexible endoscope,5068.0,2534.0,1236.88,6892.48,32
HCPCS,45388,Destruction of polyp or growth of large bowel using a flexible endoscope,6204.0,3102.0,1236.88,8437.44,32
HCPCS,45389,Insertion of stent in large bowel using a flexible endoscope,9308.0,4654.0,2542.8,12658.88,32
HCPCS,45390,Removal of large bowel tissue using a flexible endoscope,6779.0,3389.5,2033.7,9219.44,32
HCPCS,45391,Ultrasound exam of large bowel using a flexible endoscope,5875.0,2937.5,1236.88,7990.0,32
HCPCS,45392,Fine needle aspiration and/or biopsy of large bowel with ultrasound guidance using a flexible endoscope,6582.0,3291.0,1540.78,8951.52,32
HCPCS,45393,Decompression of twisted or abnormally dilated large bowel using a flexible endoscope,5704.0,2852.0,1236.88,7757.44,32
HCPCS,45398,Banding of hemorrhoids using a flexible endoscope (colonoscope),5376.0,2688.0,1236.88,7311.36,32
HCPCS,45399,Other procedure on large bowel,3435.0,1717.5,1030.5,4671.6,32
HCPCS,45915,Removal of impacted stool or foreign body in rectum under anesthesia,2417.0,1208.5,725.1,3287.12,32
HCPCS,46040,Drainage of deep abscess in rectum,5115.0,2557.5,1534.5,6956.4,96
HCPCS,46050,Drainage of superficial rectal abscess surrounding anus,3265.0,1632.5,979.5,4440.4,96
HCPCS,46083,Incision of external hemorrhoid with blood clot,699.0,349.5,209.7,1913.38,64
HCPCS,46220,Removal of single external noncancer growth of anus,4882.0,2441.0,1464.6,6639.52,32
HCPCS,46221,Removal of external hemorrhoids by rubber banding,2599.0,1299.5,779.7,3534.64,32
HCPCS,46230,Removal of multiple external noncancer growths of anus,9350.0,4675.0,1805.07,12716.0,32
HCPCS,46320,Removal of external hemorrhoid with blood clot,4760.0,2380.0,1428.0,6473.6,32
HCPCS,46505,Injection of agent to destroy nerve to internal sphincter of anus,3563.0,1781.5,1068.9,4845.68,32
HCPCS,46600,Diagnostic exam of anus using an endoscope,1112.0,556.0,171.32,1512.32,64
HCPCS,46916,Electrical destruction of growth of anus,536.0,268.0,160.8,1913.38,32
HCPCS,46922,Simple removal of growth of anus,4764.0,2382.0,1429.2,6479.04,32
HCPCS,46924,Extensive destruction of growth of anus,4811.0,2405.5,1443.3,6542.96,32
HCPCS,47000,Needle biopsy of liver through skin,3751.0,1875.5,905.56,5101.36,32
HCPCS,47382,Destruction of growth of liver through skin using radiofrequency,12581.0,6290.5,3774.3,17110.16,32
HCPCS,47399,Other procedure on liver,2773.0,1386.5,831.9,3771.28,32
HCPCS,47490,Insertion of tube into gallbladder using imaging guidance with review by radiologist,5799.0,2899.5,1739.7,7886.64,32
HCPCS,47531,Injection of bile duct for X-ray through already existing skin access using imaging guidance with review by radiologist,5518.0,2759.0,1655.4,7504.48,32
HCPCS,47532,Injection of bile duct for X-ray through new skin access using imaging guidance with review by radiologist,5685.0,2842.5,1705.5,7731.6,32
HCPCS,47533,Placement of external drainage tube of biliary duct using imaging guidance with review by radiologist,6316.0,3158.0,1894.8,8589.76,32
HCPCS,47534,Placement of internal-external drainage tube of biliary duct using imaging guidance with review by radiologist,6443.0,3221.5,1932.9,8762.48,32
HCPCS,47535,Conversion of external biliary drainage tube to internal-external biliary drainage tube using imaging guidance and study of bile duct with review by radiologist,6192.0,3096.0,1857.6,8421.12,32
HCPCS,47536,Replacement of liver duct drainage tube using imaging guidance with review by radiologist,6130.0,3065.0,1839.0,8336.8,32
HCPCS,47537,Removal of biliary drainage tube using imaging guidance with review by radiologist,2802.0,1401.0,488.25,3810.72,32
HCPCS,47538,Placement of stent of biliary duct through existing skin access using imaging guidance with review by radiologist,10035.0,5017.5,2780.12,13647.6,32
HCPCS,47540,Placement of stent and drainage tube of biliary duct using imaging guidance with review by radiologist,9306.0,4653.0,2791.8,12656.16,32
HCPCS,47542,Balloon dilation of bile duct using imaging guidance with review by radiologist,8875.0,4437.5,2662.5,12070.0,32
HCPCS,47543,Biopsy of bile duct or liver duct using imaging guidance with review by radiologist,3118.0,1559.0,935.4,7213.17,32
HCPCS,47999,Other procedure on bile duct,4178.0,2089.0,1167.83,5682.08,32
HCPCS,48102,Needle biopsy of pancreas,3351.0,1675.5,905.56,4557.36,32
HCPCS,48999,Other procedure on pancreas,10237.0,5118.5,911.78,13922.32,32
HCPCS,49082,Drainage of fluid from abdominal cavity,2098.0,1049.0,629.4,2853.28,64
HCPCS,49083,Drainage of fluid from abdominal cavity using imaging guidance,2605.0,1302.5,781.5,3542.8,96
HCPCS,49180,Needle biopsy of growth of abdominal cavity,4588.0,2294.0,905.56,6239.68,32
HCPCS,49185,Injection of chemical agent into fluid collection using imaging guidance,4145.0,2072.5,905.56,5637.2,32
HCPCS,49320,Diagnostic exam of abdomen using an endoscope,10035.0,5017.5,3010.5,13647.6,32
HCPCS,49405,Drainage of fluid collection by tube through skin using imaging guidance,4461.0,2230.5,905.56,6066.96,64
HCPCS,49406,Drainage of fluid collection of abdominal cavity by tube using imaging guidance,3797.0,1898.5,905.56,5163.92,64
HCPCS,49418,Insertion of abdominal tube using imaging guidance with review by radiologist,7124.0,3562.0,2137.2,9688.64,32
HCPCS,49421,Insertion of abdominal cavity tube for drainage or dialysis,7037.0,3518.5,2111.1,9570.32,32
HCPCS,49422,Removal of abdominal cavity tube,6002.0,3001.0,905.56,8162.72,32
HCPCS,49423,Exchange of abdominal cavity drainage tube using imaging guidance,4386.0,2193.0,905.56,5964.96,32
HCPCS,49424,Injection of contrast through abdominal cavity tube for X-ray study,1127.0,563.5,338.1,1532.72,32
HCPCS,49440,Insertion of stomach tube using fluoroscopic guidance with contrast,3263.0,1631.5,488.25,4437.68,32
HCPCS,49441,Insertion of small bowel tube using fluoroscopic guidance with contrast,3329.0,1664.5,488.25,4527.44,32
HCPCS,49446,Conversion of stomach tube to stomach-to-small bowel tube using fluoroscopic guidance with contrast,3296.0,1648.0,488.25,4482.56,32
HCPCS,49450,Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast,1890.0,945.0,488.25,2570.4,32
HCPCS,49451,Replacement of small bowel tube using fluoroscopic guidance with contrast,2014.0,1007.0,488.25,2739.04,32
HCPCS,49452,Replacement of stomach-to-small bowel tube using fluoroscopic guidance with contrast,1932.0,966.0,488.25,2627.52,32
HCPCS,49465,"Contrast injection for X-ray imaging through existing tube in stomach, small bowel or large bowel",780.0,390.0,148.54,1060.8,32
HCPCS,49520,Repair of groin hernia that is not trapped,8755.0,4377.5,2626.5,11906.8,32
HCPCS,49999,Other procedure on abdomen,4442.0,2221.0,905.56,6041.12,64
HCPCS,50200,Needle biopsy of kidney,3890.0,1945.0,1167.0,5290.4,64
HCPCS,50382,Removal and replacement of stent in ureter with review by radiologist,5540.0,2770.0,1662.0,7534.4,32
HCPCS,50384,Removal of stent in ureter through skin with review by radiologist,5508.0,2754.0,1652.4,7490.88,32
HCPCS,50387,Removal and replacement of stent in kidney and ureter using fluoroscopic guidance with review by radiologist,4787.0,2393.5,1436.1,6510.32,32
HCPCS,50389,Removal of kidney drainage tube using fluoroscopic guidance,2335.0,1167.5,506.45,3175.6,32
HCPCS,50390,Aspiration and/or injection of cyst of kidney,3972.0,1986.0,506.45,5401.92,32
HCPCS,50391,Instillation of drug into kidney and/or ureter,1526.0,763.0,321.7,2075.36,32
HCPCS,50430,Injection procedure for imaging of kidney and ureter through new skin access using imaging guidance with review by radiologist,1529.0,764.5,458.7,2079.44,32
HCPCS,50431,Injection procedure for imaging of kidney and ureter through already existing skin access using imaging guidance with review by radiologist,3784.0,1892.0,506.45,5146.24,32
HCPCS,50432,Placement of tube of kidney using imaging guidance with review by radiologist,4629.0,2314.5,1388.7,6295.44,32
HCPCS,50433,Placement of tube of kidney and urinary tube through new skin access using imaging guidance with review by radiologist,5932.0,2966.0,1779.6,8067.52,32
HCPCS,50434,Conversion of kidney tube to nephroureteral tube using imaging guidance and study of kidney and ureter with review by radiologist,4392.0,2196.0,1317.6,5973.12,32
HCPCS,50435,Replacement of kidney drainage tube using imaging guidance with review by radiologist,4392.0,2196.0,1317.6,5973.12,32
HCPCS,50436,Dilation of existing opening into urinary tract using imaging guidance,5393.0,2696.5,1617.9,7334.48,32
HCPCS,50592,Destruction of growth of kidney using radiofrequency,10035.0,5017.5,3010.5,13647.6,32
HCPCS,50593,Destruction of growth of kidney by freezing,16279.0,8139.5,4883.7,22139.44,32
HCPCS,50688,Change of tube or stent in ureter,3523.0,1761.5,1056.9,4791.28,32
HCPCS,50690,Injection of bladder and ureter for imaging,1549.0,774.5,411.09,2106.64,32
HCPCS,50693,Placement of stent of ureter through existing skin access using imaging guidance with review by radiologist,7293.0,3646.5,2187.9,9918.48,32
HCPCS,50694,Placement of stent of ureter through new skin access using imaging guidance with review by radiologist,6962.0,3481.0,2088.6,9468.32,32
HCPCS,50706,Balloon dilation treatment of stricture of ureter using imaging guidance with review by radiologist,7925.0,3962.5,2377.5,10778.0,32
HCPCS,51102,Aspiration of bladder with insertion of bladder tube to skin,4392.0,2196.0,1317.6,5973.12,32
HCPCS,51600,Injection procedure for imaging of bladder during voiding,1110.0,555.0,333.0,1509.6,32
HCPCS,51610,Injection procedure through bladder and urethra for X-ray imaging,1591.0,795.5,411.09,2163.76,64
HCPCS,51700,Simple bladder irrigation and/or instillation,1033.0,516.5,108.16,1404.88,96
HCPCS,51701,Insertion of temporary bladder tube,479.0,239.5,108.16,651.44,96
HCPCS,51702,Simple insertion of temporary bladder tube,344.0,172.0,103.2,467.84,96
HCPCS,51703,Complicated insertion of bladder tube,642.0,321.0,108.16,873.12,96
HCPCS,51705,Simple change of bladder tube,772.0,386.0,108.16,1049.92,96
HCPCS,51710,Complicated change of bladder tube,1529.0,764.5,458.7,2079.44,64
HCPCS,51715,Injection of implant material beneath lining of bladder and/or urethra using an endoscope,5932.0,2966.0,1779.6,8067.52,32
HCPCS,51720,Instillation of anti-cancer drug into bladder,2124.0,1062.0,506.45,2888.64,32
HCPCS,51726,Complex measurement of pressure of urine flow in bladder,863.0,431.5,258.9,1173.68,32
HCPCS,51727,Complex measurement of pressure of urine flow in bladder with urethra pressure studies,1380.0,690.0,414.0,1876.8,32
HCPCS,51728,Complex measurement of pressure of urine flow in bladder with voiding pressure studies,1573.0,786.5,471.9,2139.28,32
HCPCS,51729,Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies,2029.0,1014.5,506.45,2759.44,32
HCPCS,51741,Electronic assessment of bladder emptying,646.0,323.0,193.8,878.56,32
HCPCS,51784,Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings,635.0,317.5,165.68,863.6,32
HCPCS,51785,Needle measurement and recording of electrical activity of muscles at bladder and bowel openings,1198.0,599.0,166.38,1629.28,32
HCPCS,51797,Insertion of device into abdomen with pressure and urine flow rate study,783.0,391.5,108.16,1064.88,32
HCPCS,51798,Ultrasound measurement of bladder capacity after voiding,342.0,171.0,75.96,465.12,64
HCPCS,51860,"Suture of simple wound, injury, or rupture of bladder",15905.0,7952.5,4771.5,21630.8,32
HCPCS,52000,Diagnostic exam of bladder and urethra using an endoscope,3796.0,1898.0,897.83,5162.56,32
HCPCS,52001,Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope,6051.0,3025.5,1815.3,8229.36,32
HCPCS,52005,Insertion of tube into ureter using an endoscope through bladder area,4392.0,2196.0,1317.6,5973.12,32
HCPCS,52204,Biopsy of bladder using an endoscope,6236.0,3118.0,1870.8,8480.96,32
HCPCS,52214,"Destruction of tissue of bladder, urethra, or surrounding glands using an endoscope",5932.0,2966.0,1779.6,8067.52,32
HCPCS,52281,Dilation of urethra using an endoscope,5862.0,2931.0,1758.6,7972.32,32
HCPCS,52287,Exam with injections of chemical for destruction of bladder using an endoscope,6618.0,3309.0,1954.24,9000.48,32
HCPCS,52310,"Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope",9527.0,4763.5,1954.24,12956.72,32
HCPCS,52315,"Complicated removal of foreign body, stone, or stent in urethra or bladder using an endoscope",11003.0,5501.5,1954.24,14964.08,32
HCPCS,53601,Subsequent dilation of stricture of urethra in male by passage of dilator,377.0,188.5,108.16,512.72,32
HCPCS,53660,Initial dilation of urethra in female,360.0,180.0,108.0,489.6,32
HCPCS,53661,Subsequent dilation of urethra in female,283.0,141.5,84.9,384.88,32
HCPCS,53899,Other procedure on urinary system,3962.0,1981.0,321.7,5388.32,32
HCPCS,54056,Simple destruction of growth of penis using freezing,975.0,487.5,258.34,1326.0,32
HCPCS,54060,Removal of growth of penis,3908.0,1954.0,1172.4,5314.88,32
HCPCS,54065,Destruction of multiple growths of penis,3003.0,1501.5,900.9,4084.08,32
HCPCS,54100,Biopsy of penis,3739.0,1869.5,1121.7,5085.04,32
HCPCS,54150,Removal of foreskin using clamp or device,5280.0,2640.0,1584.0,7180.8,32
HCPCS,54200,Injection procedure to correct thickened penile tissue,690.0,345.0,108.16,938.4,32
HCPCS,54220,Injection of drug into erectile tissue at sides and back of penis,963.0,481.5,108.16,1309.68,64
HCPCS,54235,Injection procedure to cause erection,1045.0,522.5,108.16,1421.2,64
HCPCS,54450,Repositioning of foreskin including scar tissue removal,609.0,304.5,182.7,828.24,64
HCPCS,54700,"Incision and drainage of sperm reservoir, testis, and/or scrotal area",4392.0,2196.0,1317.6,5973.12,64
HCPCS,55000,Aspiration of fluid collection in testicle and sperm reservoir,2233.0,1116.5,108.16,3036.88,32
HCPCS,55100,Drainage of abscess of scrotum,3875.0,1937.5,1162.5,5270.0,64
HCPCS,55250,Removal of sperm duct,3993.0,1996.5,1197.9,5430.48,32
HCPCS,55874,Injection of biodegradable material next to prostate,10771.0,5385.5,3231.3,14648.56,32
HCPCS,55875,Insertion of needle or tube into prostate for radiation therapy,8938.0,4469.0,2681.4,12155.68,32
HCPCS,55876,Placement of device in prostate for radiation therapy,4923.0,2461.5,1335.85,6695.28,32
HCPCS,55899,Other procedure on male genital system,1013.0,506.5,303.9,3148.04,32
HCPCS,55920,Insertion of needles or tubes into pelvic or genital organs for radiation therapy,7719.0,3859.5,2315.7,10497.84,32
HCPCS,56405,Incision and drainage of abscess of external female genitals,1637.0,818.5,265.17,2226.32,96
HCPCS,56420,Incision and drainage of abscess of female genital gland,826.0,413.0,247.8,1123.36,96
HCPCS,56501,Simple destruction of growth of external female genitals,4810.0,2405.0,1443.0,6541.6,32
HCPCS,56515,Extensive destruction of growth of external female genitals,5051.0,2525.5,1515.3,6869.36,32
HCPCS,56605,"Biopsy of growth of external female genitals, first growth",2475.0,1237.5,667.43,3366.0,32
HCPCS,56606,"Biopsy of growth of external female genitals, each additional growth",928.0,464.0,278.4,1262.08,32
HCPCS,56821,Exam and biopsy of external female genitals using an endoscope,734.0,367.0,220.2,998.24,32
HCPCS,57022,Incision and drainage of vaginal blood accumulation following delivery,4475.0,2237.5,1342.5,6086.0,32
HCPCS,57100,Simple biopsy of vaginal mucous membrane,3438.0,1719.0,667.43,4675.68,64
HCPCS,57155,Insertion of device into uterus for radiation therapy,9715.0,4857.5,2914.5,13212.4,64
HCPCS,57156,Insertion of device into vagina for radiation therapy,1581.0,790.5,392.37,2150.16,64
HCPCS,57160,Fitting and insertion of vaginal support device,549.0,274.5,164.7,746.64,32
HCPCS,57410,Pelvic exam under anesthesia,5469.0,2734.5,265.17,7437.84,32
HCPCS,57415,Removal of impacted foreign body in vagina under anesthesia,7094.0,3547.0,2128.2,9647.84,32
HCPCS,57452,Exam of cervix and upper part of vagina using an endoscope,799.0,399.5,239.7,1086.64,32
HCPCS,57454,Biopsy and scraping of cervix using an endoscope,1167.0,583.5,350.1,1587.12,32
HCPCS,57455,Biopsy of cervix using an endoscope,1153.0,576.5,345.9,1568.08,32
HCPCS,57456,Scraping of cervix using an endoscope,1352.0,676.0,392.37,1838.72,32
HCPCS,57460,Biopsy of cervix using an endoscope with loop electrode,5749.0,2874.5,1724.7,7818.64,32
HCPCS,57500,Biopsy of cervix or removal of growth,2415.0,1207.5,667.43,3284.4,32
HCPCS,57505,Scraping of tissue of cervix,2376.0,1188.0,667.43,3231.36,32
HCPCS,57522,Removal or destruction of cervix using loop electrode,5675.0,2837.5,1702.5,7718.0,32
HCPCS,58100,Biopsy of lining of uterus,1352.0,676.0,260.32,1838.72,32
HCPCS,58110,Exam of cervix using an endoscope with biopsy of lining of uterus,939.0,469.5,281.7,1277.04,32
HCPCS,58120,Dilation and scraping of uterus,7648.0,3824.0,2294.4,10401.28,32
HCPCS,58300,Insertion of IUD for pregnancy prevention,1502.0,751.0,265.17,2042.72,64
HCPCS,58301,Removal of IUD,901.0,450.5,265.17,1225.36,96
HCPCS,58340,Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes,853.0,426.5,255.9,1160.08,64
HCPCS,58345,Insertion of tube into fallopian tube,4972.0,2486.0,1491.6,6761.92,64
HCPCS,58605,Tying or incision of fallopian tubes during same hospitalization,3500.0,1750.0,1050.0,4760.0,32
HCPCS,58611,Tying or incision of fallopian tubes during cesarean delivery or other abdominal surgery,2800.0,1400.0,840.0,3808.0,32
HCPCS,58720,Removal of uterine tubes and ovaries,5092.0,2546.0,1527.6,6925.12,32
HCPCS,58970,Removal of eggs from ovaries,4500.0,2250.0,512.67,6120.0,32
HCPCS,58974,Injection of fertilized eggs into uterus,1813.0,906.5,512.67,2465.68,32
HCPCS,58999,Other procedure on female genital system (nonobstetrical),2624.0,1312.0,260.32,3568.64,32
HCPCS,59000,Removal of sample of amniotic fluid surrounding fetus for diagnosis,1728.0,864.0,518.4,2350.08,32
HCPCS,59015,Removal of tissue from placenta for diagnosis,1813.0,906.5,543.9,2465.68,32
HCPCS,59020,Fetal contraction stress test,641.0,320.5,192.3,871.76,64
HCPCS,59025,Fetal test,975.0,487.5,242.91,1326.0,64
HCPCS,59074,Drainage of fetal fluid using ultrasound guidance,476.0,238.0,142.8,647.36,32
HCPCS,59160,Scraping of lining of uterus after delivery,5060.0,2530.0,1518.0,6881.6,32
HCPCS,59200,Insertion of dilator device into cervix,1150.0,575.0,345.0,1564.0,64
HCPCS,59300,Episiotomy or repair of vagina,4972.0,2486.0,1491.6,6761.92,32
HCPCS,59320,Suture of cervix during pregnancy through vagina,7620.0,3810.0,2125.76,10363.2,32
HCPCS,59400,Vaginal delivery with care before and after delivery,8965.0,4482.5,2689.5,12192.4,32
HCPCS,59409,Vaginal delivery,7460.0,3730.0,2238.0,10145.6,64
HCPCS,59412,Turning of fetus through external manipulation,5464.0,2732.0,724.12,7431.04,64
HCPCS,59414,Delivery of placenta,4972.0,2486.0,1491.6,6761.92,32
HCPCS,59510,Cesarean delivery with care before and after delivery,7629.0,3814.5,2288.7,10375.44,32
HCPCS,59525,Cesarean delivery with removal of uterus,3600.0,1800.0,1080.0,5475.88,32
HCPCS,59610,Vaginal delivery and care before and after delivery after previous cesarean delivery,8500.0,4250.0,2550.0,11560.0,32
HCPCS,59812,Treatment of miscarriage,7094.0,3547.0,2128.2,9647.84,64
HCPCS,59840,Induced abortion by dilation and scraping of uterine,9334.0,4667.0,2170.29,12694.24,64
HCPCS,59841,Induced abortion by dilation,6350.0,3175.0,1905.0,8636.0,64
HCPCS,59871,Removal of suture of cervix under anesthesia,4972.0,2486.0,1491.6,6761.92,64
HCPCS,59897,Other procedure on fetus,735.0,367.5,220.5,999.6,32
HCPCS,59899,Other maternity care and delivery procedure,2196.0,1098.0,103.2,5505.28,96
HCPCS,60100,Needle biopsy of thyroid through skin,2196.0,1098.0,658.8,2986.56,64
HCPCS,60300,Aspiration and/or injection of cyst of thyroid,1465.0,732.5,439.5,1992.4,64
HCPCS,60660,Destruction using heat of one or more nodules on one thyroid lobe,5453.0,2726.5,1635.9,7416.08,28
HCPCS,60661,Destruction using heat of one or more nodules on additional thyroid lobe,4457.0,2228.5,1337.1,6061.52,28
HCPCS,61026,Removal of cerebrospinal fluid from brain and injection of substance,1691.0,845.5,507.3,2299.76,64
HCPCS,61070,Aspiration of cerebrospinal fluid and injection in shunt tubing or reservoir,1814.0,907.0,500.68,2467.04,32
HCPCS,61107,Creation of opening in skull for insertion of brain tube or monitoring device,2800.0,1400.0,840.0,7095.56,32
HCPCS,61623,Balloon occlusion of head or neck artery with review by radiologist,19289.0,9644.5,5786.7,26233.04,32
HCPCS,61624,Occlusion of central nervous system or spinal cord artery,20930.0,10465.0,6279.0,28464.8,32
HCPCS,61626,Occlusion of head or neck artery,28259.0,14129.5,8477.7,38432.24,64
HCPCS,61630,Balloon dilation of blood vessel in head,4713.0,2356.5,1413.9,18704.53,32
HCPCS,61635,Insertion of stent in blood vessel of head,5828.0,2914.0,1748.4,18704.53,32
HCPCS,61645,Removal of blood clot and injection to dissolve blood clot from head artery using fluoroscopic guidance,10297.0,5148.5,3089.1,18704.53,32
HCPCS,61650,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, initial territory",4224.0,2112.0,1267.2,18704.53,32
HCPCS,61651,"Infusion of chemical agent into artery of brain with insertion of tube and imaging, each additional territory",3119.0,1559.5,935.7,18704.53,32
HCPCS,61715,"MRI guided high intensity focused ultrasound, computer-assisted destruction of intracranial tissue",37411.0,18705.5,625.0,50878.96,28
HCPCS,62267,Aspiration of spinal disc tissue for diagnostic purposes,1621.0,810.5,486.3,2204.56,32
HCPCS,62270,Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test,1821.0,910.5,546.3,2476.56,96
HCPCS,62272,Removal of cerebrospinal fluid with lower back spinal tap,1870.0,935.0,561.0,2543.2,64
HCPCS,62273,Injection of blood or blood clot into spinal canal,2063.0,1031.5,618.9,2805.68,64
HCPCS,62284,Injection of contrast for imaging of lower spinal canal,1142.0,571.0,342.6,1553.12,32
HCPCS,62290,Injection of contrast for imaging of each level of lower spine,1950.0,975.0,411.09,2652.0,32
HCPCS,62302,X-ray of upper spinal canal with review by radiologist,2437.0,1218.5,296.03,3314.32,32
HCPCS,62304,X-ray of lower spinal canal with review by radiologist,2384.0,1192.0,254.54,3242.24,32
HCPCS,62305,X-ray of multiple regions of spinal canal with review by radiologist,3018.0,1509.0,381.25,4104.48,32
HCPCS,62321,Injection of substance into middle or upper spine canal using imaging guidance,2063.0,1031.5,618.9,2805.68,32
HCPCS,62323,Injection of substance into lower spine canal using imaging guidance,2467.0,1233.5,740.1,3355.12,32
HCPCS,62328,Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance,3332.0,1666.0,908.89,4531.52,32
HCPCS,62329,Removal of cerebrospinal fluid with lower back spinal tap using imaging guidance,3411.0,1705.5,908.89,4638.96,32
HCPCS,62367,Electronic analysis of spinal canal drug infusion pump,737.0,368.5,178.73,1002.32,32
HCPCS,62368,Electronic analysis and reprogramming of spinal canal drug infusion pump,1008.0,504.0,178.73,1370.88,32
HCPCS,62370,Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician,2104.0,1052.0,178.73,2861.44,32
HCPCS,64400,Injection of anesthetic agent and/or steroid into face nerve,1125.0,562.5,337.5,1530.0,64
HCPCS,64405,Injection of anesthetic agent and/or steroid into upper neck and back of head nerve,1250.0,625.0,375.0,1700.0,64
HCPCS,64408,Injection of anesthetic agent and/or steroid into vagus nerve,1227.0,613.5,368.1,1668.72,64
HCPCS,64418,Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve,1979.0,989.5,500.68,2691.44,64
HCPCS,64420,Injection of anesthetic agent and/or steroid into rib nerve,1538.0,769.0,461.4,2091.68,32
HCPCS,64421,Injection of anesthetic agent and/or steroid into multiple rib nerves for regional nerve block,1850.0,925.0,555.0,2516.0,32
HCPCS,64430,Injection of anesthetic agent and/or steroid into external genitals and anus nerve,2703.0,1351.5,810.9,3676.08,32
HCPCS,64445,Injection of anesthetic agent and/or steroid into lower back and leg nerve (sciatic nerve),2228.0,1114.0,500.68,3030.08,32
HCPCS,64447,Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve),2081.0,1040.5,624.3,2830.16,32
HCPCS,64450,Injection of anesthetic agent and/or steroid into other nerve or branch,1931.0,965.5,500.68,2626.16,96
HCPCS,64461,"Injection of anesthetic agent into thoracic vertebra using imaging guidance, single site",2397.0,1198.5,719.1,3259.92,32
HCPCS,64466,Unilateral thoracic fascial plane block by injection(s),959.0,479.5,287.7,1304.24,28
HCPCS,64468,Bilateral thoracic fascial plane block by injection(s),1744.0,872.0,523.2,2371.84,28
HCPCS,64473,Unilateral lower extremity fascial plane block by injection(s),950.0,475.0,285.0,1292.0,28
HCPCS,64483,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level",2199.0,1099.5,659.7,2990.64,64
HCPCS,64484,"Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level",1476.0,738.0,442.8,2007.36,32
HCPCS,64490,"Injection of upper or middle spine facet joint using imaging guidance, single level",2948.0,1474.0,884.4,4009.28,32
HCPCS,64491,"Injection of upper or middle spine facet joint using imaging guidance, second level",1510.0,755.0,453.0,2053.6,32
HCPCS,64493,"Injection of lower or sacral spine facet joint using imaging guidance, single level",2388.0,1194.0,716.4,3247.68,64
HCPCS,64494,"Injection of lower or sacral spine facet joint using imaging guidance, second level",1021.0,510.5,306.3,1388.56,32
HCPCS,64530,Injection of anesthetic agent into abdominal sympathetic nerve bundle,2955.0,1477.5,886.5,4018.8,32
HCPCS,64555,Insertion of peripheral nerve neurostimulator electrode through skin,19256.0,9628.0,5776.8,26188.16,32
HCPCS,64561,Insertion of sacral nerve neurostimulator electrode array,19250.0,9625.0,5775.0,26180.0,32
HCPCS,64566,Insertion of lower leg neurostimulator electrode,869.0,434.5,260.7,1181.84,32
HCPCS,64610,Destruction of face nerve branch under X-ray monitoring,4431.0,2215.5,1329.3,6026.16,32
HCPCS,64611,Injection of chemical for paralysis of salivary glands on both sides of mouth,751.0,375.5,225.3,1021.36,32
HCPCS,64612,Injection of chemical for paralysis of nerve muscles on side of face,1469.0,734.5,395.23,1997.84,32
HCPCS,64615,Injection of chemical for paralysis of facial and neck nerve muscles on both sides of face,1558.0,779.0,395.23,2118.88,32
HCPCS,64616,Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box,1143.0,571.5,342.9,1554.48,32
HCPCS,64617,Injection of chemical for paralysis of nerve muscles on side of voice box,1259.0,629.5,377.7,1712.24,32
HCPCS,64640,Destruction of peripheral nerve or branch,3421.0,1710.5,1026.3,4652.56,32
HCPCS,64642,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity",1815.0,907.5,500.68,2468.4,32
HCPCS,64643,"Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity",1025.0,512.5,307.5,1394.0,32
HCPCS,64644,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity",1906.0,953.0,500.68,2592.16,32
HCPCS,64645,"Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, each additional extremity",1128.0,564.0,338.4,1534.08,32
HCPCS,64646,"Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles",1869.0,934.5,500.68,2541.84,32
HCPCS,64647,"Injection of chemical for paralysis of nerve muscles on trunk, 6 or more muscles",2158.0,1079.0,500.68,2934.88,32
HCPCS,64650,Injection of chemical for paralysis of underarm sweat glands,672.0,336.0,201.6,913.92,32
HCPCS,64653,Injection of chemical for paralysis of sweat glands,687.0,343.5,206.1,934.32,32
HCPCS,64999,Other procedure on nervous system,2685.5,1342.75,289.8,5990.8,64
HCPCS,65205,Removal of foreign body from external eye (conjunctiva),595.0,297.5,94.55,809.2,64
HCPCS,65210,Removal of foreign body from external eye (conjunctiva or sclera),796.0,398.0,94.55,1082.56,32
HCPCS,65220,Removal of foreign body in cornea,845.0,422.5,94.55,1149.2,64
HCPCS,65222,Removal of foreign body in cornea using slit lamp,588.0,294.0,94.55,799.68,96
HCPCS,65285,Repair of perforating laceration of cornea and/or sclera with reposition or removal of uveal tissue,8875.0,4437.5,2662.5,12070.0,32
HCPCS,65286,Repair of lacerated cornea and/or sclera using tissue glue,4697.0,2348.5,714.21,6387.92,32
HCPCS,65400,Removal of growth of cornea,5454.0,2727.0,714.21,7417.44,32
HCPCS,65435,Removal of outer layer of cornea,1774.0,887.0,532.2,2412.64,32
HCPCS,65772,Incision of cornea to correct astigmatism,2162.0,1081.0,648.6,2940.32,32
HCPCS,65800,Removal of eye fluid,6381.0,3190.5,1264.82,8678.16,32
HCPCS,65855,Laser repair to improve eye fluid flow,2438.0,1219.0,708.17,3315.68,32
HCPCS,66020,Injection of air or liquid into eye,6188.0,3094.0,1264.82,8415.68,32
HCPCS,66250,Revision or repair of operative wound of eye,5470.0,2735.0,1264.82,7439.2,32
HCPCS,66710,Destruction of lens tissue using laser,5262.0,2631.0,1264.82,7156.32,32
HCPCS,66761,"Creation of eye fluid drainage tracts in iris using a laser, per session",1746.0,873.0,523.8,2374.56,32
HCPCS,66821,Removal of recurring cataract in lens capsule using a laser,3381.0,1690.5,708.17,4598.16,32
HCPCS,67028,Injection of drug into eye,1351.0,675.5,362.6,1837.36,32
HCPCS,67031,Release of scar tissue between lens and retina using a laser,1763.0,881.5,528.9,2397.68,32
HCPCS,67110,Repair of detached retina by injection of air or gas,4714.0,2357.0,1287.45,6411.04,32
HCPCS,67145,Photocoagulation treatment to prevent detachment of retina,3277.0,1638.5,708.17,4456.72,32
HCPCS,67210,Destruction of growth of retina using a laser,3438.0,1719.0,708.17,4675.68,32
HCPCS,67228,Destruction of leaking blood vessels of retina using laser,4220.0,2110.0,708.17,5739.2,32
HCPCS,67400,Exploration of cavity behind eye,8201.0,4100.5,2460.3,11153.36,32
HCPCS,67700,Incision and drainage of abscess of eyelid,1241.0,620.5,362.6,1687.76,64
HCPCS,67715,Incision of corner of eye at eyelid,5262.0,2631.0,1578.6,7156.32,32
HCPCS,67800,Removal of chronic growth of eyelid,2516.0,1258.0,362.6,3421.76,32
HCPCS,67801,Removal of multiple chronic growths of same eyelid,2906.0,1453.0,871.8,3952.16,32
HCPCS,67805,Removal of multiple chronic growths of different eyelids,3051.0,1525.5,362.6,4149.36,32
HCPCS,67810,Biopsy of eyelid,2068.0,1034.0,362.6,2812.48,32
HCPCS,67825,Removal of eyelashes,1060.0,530.0,318.0,1441.6,32
HCPCS,67840,Removal of growth of eyelid,3563.0,1781.5,1068.9,4845.68,32
HCPCS,67850,"Destruction of growth of eyelid margin, 1.0 cm or less",1693.0,846.5,362.6,2302.48,32
HCPCS,67880,Creation of permanent eyelid margin scarring,6519.0,3259.5,1659.96,8865.84,32
HCPCS,67930,Suture of recent wound of eyelid,5224.0,2612.0,1567.2,7104.64,64
HCPCS,67935,Repair of wound of eyelid margin,5905.0,2952.5,1659.96,8030.8,64
HCPCS,67938,Removal of embedded foreign body in eyelid,1104.0,552.0,331.2,1501.44,64
HCPCS,67961,Removal of up to 1/4 of eyelid margin and repair of eyelid,5262.0,2631.0,1578.6,7156.32,32
HCPCS,68100,Biopsy of eyelid lining,4978.0,2489.0,1493.4,6770.08,32
HCPCS,68110,"Removal of growth of eyelid lining, 1.0 cm or less",5269.0,2634.5,1264.82,7165.84,32
HCPCS,68115,"Removal of growth of eyelid lining, more than 1.0 cm",5533.0,2766.5,1659.9,7524.88,32
HCPCS,68440,Snip incision of tear duct at inner corner of eye,1012.0,506.0,303.6,1376.32,32
HCPCS,68510,Biopsy of tear producing gland,5262.0,2631.0,1578.6,7156.32,32
HCPCS,68525,Biopsy of tear sac,3648.0,1824.0,1094.4,4961.28,32
HCPCS,68700,Plastic repair of tear duct,3648.0,1824.0,1094.4,4961.28,32
HCPCS,68761,Closure of tear duct opening using plug,1026.0,513.0,307.8,1395.36,32
HCPCS,68840,Probing of nasal tear duct,1500.0,750.0,362.6,2040.0,32
HCPCS,68850,Injection of contrast for imaging of tear sac,223.0,111.5,66.9,435.76,32
HCPCS,69000,Simple drainage of abscess or blood accumulation of external ear,1574.0,787.0,212.62,2140.64,96
HCPCS,69005,Complicated drainage of external ear abscess or blood accumulation,3254.0,1627.0,976.2,4425.44,32
HCPCS,69100,Biopsy of ear,1307.0,653.5,212.62,1777.52,32
HCPCS,69105,Biopsy of ear canal,4120.0,2060.0,1236.0,5603.2,32
HCPCS,69200,Removal of foreign body in ear canal,428.0,214.0,128.4,582.08,84
HCPCS,69209,Removal of impacted ear wax by washing,281.5,140.75,67.5,459.68,112
HCPCS,69210,Removal of impacted ear wax,316.5,158.25,75.9,516.8,112
HCPCS,69220,Simple removal of skin debris and drainage of mastoid cavity,880.0,440.0,212.62,1196.8,32
HCPCS,69222,Complex removal of skin debris and drainage of mastoid cavity,4104.0,2052.0,694.44,5581.44,32
HCPCS,69420,"Incision, aspiration, and/or inflation of eardrum",1893.0,946.5,212.62,2574.48,32
HCPCS,69433,Incision of eardrum with insertion of eardrum tube under local or topical anesthesia,3558.0,1779.0,212.62,4838.88,32
HCPCS,69436,Incision of eardrum with placement of eardrum tube under general anesthesia,5095.0,2547.5,1528.5,6929.2,32
HCPCS,69610,Repair of eardrum,4389.0,2194.5,1316.7,5969.04,32
HCPCS,69801,Incision of fluid canal of inner ear with infusion of drugs,4513.0,2256.5,1353.9,6137.68,32
HCPCS,70030,X-ray of eye for detection of foreign body,158.0,79.0,25.79,214.88,32
HCPCS,70100,"X-ray of part of lower jaw, 1-4 views",328.0,164.0,32.53,446.08,32
HCPCS,70110,"X-ray of lower jaw, minimum of 4 views",414.0,207.0,38.12,563.04,32
HCPCS,70140,"X-ray of face bones, 1-2 views",338.0,169.0,35.05,459.68,32
HCPCS,70150,"X-ray of face bones, minimum of 3 views",429.0,214.5,49.33,583.44,32
HCPCS,70160,"X-ray of nose bones, minimum of 3 views",375.0,187.5,32.53,510.0,32
HCPCS,70170,Review by radiologist of tear drainage structure of eye image,947.0,473.5,59.43,1287.92,32
HCPCS,70200,"X-ray of eye socket, minimum of 4 views",469.0,234.5,49.33,637.84,32
HCPCS,70220,"X-ray of paranasal sinus, minimum of 3 views",459.0,229.5,45.45,624.24,32
HCPCS,70250,"X-ray of skull, 1-3 views",390.0,195.0,38.12,530.4,32
HCPCS,70260,"X-ray of skull, minimum of 4 views",465.0,232.5,51.29,632.4,32
HCPCS,70330,X-ray of jaw joints on both sides of mouth,417.0,208.5,51.58,567.12,32
HCPCS,70336,MRI scan of jaw joint,3026.0,1513.0,302.84,4115.36,32
HCPCS,70355,"X-ray of lower jaws, upper jaws and teeth",392.0,196.0,17.5,533.12,32
HCPCS,70360,X-ray of soft tissue of neck,368.0,184.0,25.79,500.48,32
HCPCS,70450,CT scan head or brain without contrast,1803.0,901.5,134.61,2452.08,32
HCPCS,70460,CT scan head or brain with contrast,2484.0,1242.0,225.85,3378.24,32
HCPCS,70470,CT scan of head or brain before and after contrast,2959.0,1479.5,225.85,4024.24,32
HCPCS,70480,CT scan of cranial cavity without contrast,2148.0,1074.0,133.94,2921.28,32
HCPCS,70481,CT scan of cranial cavity with contrast,2561.0,1280.5,225.85,3482.96,32
HCPCS,70482,CT scan of cranial cavity before and after contrast,2831.0,1415.5,225.85,3850.16,32
HCPCS,70486,CT scan of face without contrast,1983.0,991.5,133.94,2696.88,32
HCPCS,70487,CT scan of face with contrast,2202.0,1101.0,225.85,2994.72,32
HCPCS,70488,CT scan of face before and after contrast,2742.0,1371.0,225.85,3729.12,32
HCPCS,70490,CT scan of soft tissue of neck without contrast,2300.0,1150.0,133.94,3128.0,32
HCPCS,70491,CT scan of soft tissue of neck with contrast,2625.0,1312.5,225.85,3570.0,32
HCPCS,70492,CT scan of soft tissue of neck before and after contrast,2975.0,1487.5,225.85,4046.0,32
HCPCS,70496,CT scan of blood vessels of head with contrast,3047.0,1523.5,225.85,4143.92,64
HCPCS,70498,CT scan of blood vessels of neck with contrast,3131.0,1565.5,225.85,4258.16,32
HCPCS,70540,"MRI scan of bone of eye socket, face, and/or neck without contrast",2238.0,1119.0,302.84,3043.68,32
HCPCS,70542,"MRI scan of bone of eye socket, face, and/or neck with contrast",3122.0,1561.0,449.2,4245.92,32
HCPCS,70543,"MRI scan of bone of eye socket, face, and/or neck before and after contrast",3953.0,1976.5,449.2,5376.08,32
HCPCS,70544,MRI scan of blood vessels of head without contrast,2486.0,1243.0,307.22,3380.96,32
HCPCS,70545,MRI scan of blood vessels of head with contrast,2530.0,1265.0,449.2,3440.8,32
HCPCS,70546,MRI scan of blood vessels of head before and after contrast,3850.0,1925.0,449.2,5236.0,32
HCPCS,70547,MRI scan of blood vessels of neck without contrast,2503.0,1251.5,307.22,3404.08,32
HCPCS,70548,MRI scan of blood vessels of neck with contrast,2801.0,1400.5,449.2,3809.36,32
HCPCS,70549,MRI scan of blood vessels of neck before and after contrast,3214.0,1607.0,449.2,4371.04,32
HCPCS,70551,MRI scan of brain without contrast,2553.0,1276.5,302.84,3472.08,32
HCPCS,70552,MRI scan of brain with contrast,2670.0,1335.0,449.2,3631.2,32
HCPCS,70553,MRI scan of brain before and after contrast,4781.0,2390.5,449.2,6502.16,32
HCPCS,70555,Functional MRI scan of brain with neurofunctional testing,2543.0,1271.5,302.84,3458.48,32
HCPCS,71045,"X-ray of chest, 1 view",397.0,198.5,32.66,539.92,32
HCPCS,71046,"X-ray of chest, 2 views",567.0,283.5,38.11,771.12,32
HCPCS,71047,"X-ray of chest, 3 views",587.0,293.5,44.64,798.32,32
HCPCS,71048,"X-ray of chest, minimum of 4 views",746.0,373.0,47.9,1014.56,32
HCPCS,71100,"X-ray of ribs on side of body, 2 views",542.0,271.0,35.89,737.12,32
HCPCS,71101,"X-ray of ribs on side of body, minimum of 3 views",576.0,288.0,41.55,783.36,32
HCPCS,71110,"X-ray of ribs on both sides of body, 3 views",589.0,294.5,43.49,801.04,32
HCPCS,71111,"X-ray of ribs on both sides of body, minimum of 4 views",643.0,321.5,57.14,874.48,32
HCPCS,71120,"X-ray of chest bone, minimum of 2 views",431.0,215.5,35.7,586.16,32
HCPCS,71130,"X-ray of joint between breast and collar bones, minimum of 2 views",440.0,220.0,43.74,598.4,32
HCPCS,71250,CT scan of chest without contrast,2012.0,1006.0,133.94,2736.32,32
HCPCS,71260,CT scan of chest with contrast,2668.0,1334.0,225.85,3628.48,32
HCPCS,71270,CT scan of chest before and after contrast,3168.0,1584.0,225.85,4308.48,32
HCPCS,71271,Low dose CT scan of chest for lung cancer screening,2681.0,1340.5,133.94,3646.16,32
HCPCS,71275,CT scan of blood vessels of chest with contrast,3365.0,1682.5,225.85,4576.4,32
HCPCS,71550,MRI scan of chest without contrast,2857.0,1428.5,302.84,3885.52,32
HCPCS,71551,MRI scan of chest with contrast,4712.0,2356.0,510.96,6408.32,32
HCPCS,71552,MRI scan of chest before and after contrast,5295.0,2647.5,449.2,7201.2,32
HCPCS,71555,MRI scan of blood vessels of chest,4948.0,2474.0,617.13,7561.6,96
HCPCS,72020,"X-ray of spine, 1 view",269.0,134.5,26.6,365.84,32
HCPCS,72040,"X-ray of upper spine, 2-3 views",513.0,256.5,38.12,697.68,32
HCPCS,72050,"X-ray of upper spine, 4-5 views",705.0,352.5,53.24,958.8,32
HCPCS,72052,"X-ray of upper spine, 6 or more views",731.0,365.5,69.48,994.16,32
HCPCS,72070,"X-ray of middle spine, 2 views",443.0,221.5,41.49,602.48,32
HCPCS,72072,"X-ray of middle spine, 3 views",450.0,225.0,43.49,612.0,32
HCPCS,72074,"X-ray of middle spine, minimum of 4 views",683.0,341.5,51.94,928.88,32
HCPCS,72080,"X-ray of middle and lower spine, 2 views",394.0,197.0,36.35,535.84,32
HCPCS,72081,"X-ray of entire middle and lower spine, 1 view",503.0,251.5,41.49,684.08,32
HCPCS,72082,"X-ray of entire middle and lower spine, 2-3 views",566.0,283.0,63.91,769.76,32
HCPCS,72083,"X-ray of entire middle and lower spine, 4-5 views",1020.0,510.0,41.49,1387.2,32
HCPCS,72084,"X-ray of entire middle and lower spine, minimum of 6 views",1268.0,634.0,41.49,1724.48,32
HCPCS,72100,"X-ray of lower and sacral spine, 2-3 views",481.0,240.5,42.61,654.16,32
HCPCS,72110,"X-ray of lower and sacral spine, minimum of 4 views",733.0,366.5,57.19,996.88,32
HCPCS,72114,"X-ray lower and sacral spine, minimum of 6 views",1561.0,780.5,70.48,2122.96,32
HCPCS,72120,"X-ray lower and sacral spine, 2-3 views bending views",539.0,269.5,53.24,733.04,32
HCPCS,72125,CT scan of upper spine without contrast,2449.0,1224.5,133.94,3330.64,32
HCPCS,72126,CT scan of upper spine with contrast,2806.0,1403.0,381.53,3816.16,32
HCPCS,72127,CT scan of upper spine before and after contrast,3133.0,1566.5,225.85,4260.88,32
HCPCS,72128,CT scan of middle spine without contrast,2177.0,1088.5,133.94,2960.72,32
HCPCS,72129,CT scan of middle spine with contrast,2592.0,1296.0,225.85,3525.12,32
HCPCS,72130,CT scan of middle spine before and after contrast,3127.0,1563.5,225.85,4252.72,32
HCPCS,72131,CT scan of lower spine without contrast,2351.0,1175.5,133.94,3197.36,32
HCPCS,72132,CT scan of lower spine with contrast,2666.0,1333.0,381.53,3625.76,32
HCPCS,72133,CT scan of lower spine before and after contrast,2868.0,1434.0,225.85,3900.48,32
HCPCS,72141,MRI scan of upper spinal canal without contrast,3150.0,1575.0,302.84,4284.0,32
HCPCS,72142,MRI scan of upper spinal canal with contrast,3721.0,1860.5,449.2,5060.56,32
HCPCS,72146,MRI scan of middle spinal canal without contrast,3286.0,1643.0,302.84,4468.96,32
HCPCS,72147,MRI scan of middle spinal canal with contrast,4238.0,2119.0,449.2,5763.68,32
HCPCS,72148,MRI scan of lower spinal canal without contrast,3225.0,1612.5,302.84,4386.0,32
HCPCS,72149,MRI scan of lower spinal canal with contrast,3545.0,1772.5,449.2,4821.2,32
HCPCS,72156,MRI scan of upper spinal canal before and after contrast,4538.0,2269.0,449.2,6171.68,32
HCPCS,72157,MRI scan of middle spinal canal before and after contrast,4538.0,2269.0,449.2,6171.68,32
HCPCS,72158,MRI scan of lower spinal canal before and after contrast,4718.0,2359.0,449.2,6416.48,32
HCPCS,72159,MRI scan of blood vessels of spinal canal,3907.0,1953.5,617.13,6480.4,96
HCPCS,72170,"X-ray of pelvis, 1-2 views",436.0,218.0,32.53,592.96,32
HCPCS,72190,"X-ray of pelvis, minimum of 3 views",544.0,272.0,42.61,739.84,32
HCPCS,72191,CT scan of blood vessels of pelvis with contrast,3489.0,1744.5,225.85,4745.04,32
HCPCS,72192,CT scan of pelvis without contrast,2058.0,1029.0,133.94,2798.88,32
HCPCS,72193,CT scan of pelvis with contrast,2814.0,1407.0,225.85,3827.04,32
HCPCS,72194,CT scan of pelvis before and after contrast,3655.0,1827.5,225.85,4970.8,32
HCPCS,72195,MRI scan of pelvis without contrast,3205.0,1602.5,302.84,4358.8,32
HCPCS,72197,MRI scan of pelvis before and after contrast,3930.0,1965.0,449.2,5344.8,32
HCPCS,72198,MRI scan of blood vessels of pelvis,4016.0,2008.0,617.13,5612.72,96
HCPCS,72200,"X-ray of joint between lower spine and hip bone, 1-2 views",583.0,291.5,32.53,792.88,32
HCPCS,72202,"X-ray of joint between lower spine and hip bone, 3 or more views",922.0,461.0,39.25,1253.92,32
HCPCS,72220,"X-ray of sacrum and tailbone, minimum of 2 views",472.0,236.0,35.7,641.92,32
HCPCS,72295,Review by radiologist of disc of lower spine image,4028.0,2014.0,100.66,5478.08,32
HCPCS,73000,X-ray of collar bone,317.0,158.5,33.64,431.12,32
HCPCS,73010,X-ray of shoulder blade,501.0,250.5,32.53,681.36,32
HCPCS,73020,"X-ray of shoulder, 1 view",257.0,128.5,27.9,349.52,32
HCPCS,73030,"X-ray of shoulder, minimum of 2 views",675.0,337.5,35.7,918.0,32
HCPCS,73040,Review by radiologist of shoulder joint image,885.0,442.5,131.2,1203.6,32
HCPCS,73050,X-ray of both collar bones joints,381.0,190.5,41.49,518.16,32
HCPCS,73060,"X-ray of upper arm, minimum of 2 views",398.0,199.0,35.89,541.28,32
HCPCS,73070,"X-ray of elbow, 2 views",253.0,126.5,32.53,344.08,32
HCPCS,73080,"X-ray of elbow, minimum of 3 views",477.0,238.5,35.89,648.72,32
HCPCS,73090,"X-ray of forearm, 2 views",396.0,198.0,31.8,538.56,32
HCPCS,73092,"X-ray of infant arm, minimum of 2 views",287.0,143.5,31.39,390.32,32
HCPCS,73100,"X-ray of wrist, 2 views",300.0,150.0,31.39,408.0,32
HCPCS,73110,"X-ray of wrist, minimum of 3 views",311.0,155.5,32.53,422.96,32
HCPCS,73115,Review by radiologist of wrist joint image,759.0,379.5,97.56,1032.24,32
HCPCS,73120,"X-ray of hand, 2 views",362.0,181.0,31.39,492.32,32
HCPCS,73130,"X-ray of hand, minimum of 3 views",626.0,313.0,32.53,851.36,32
HCPCS,73140,"X-ray of finger, minimum of 2 views",612.0,306.0,25.79,832.32,32
HCPCS,73200,CT scan of arm without contrast,1939.0,969.5,133.94,2637.04,32
HCPCS,73201,CT scan of arm with contrast,2444.0,1222.0,368.92,3323.84,32
HCPCS,73202,CT scan of arm before and after contrast,3269.0,1634.5,225.85,4445.84,32
HCPCS,73206,CT scan of blood vessels of arm with contrast,3336.0,1668.0,225.85,4536.96,32
HCPCS,73218,MRI scan of arm without contrast,2185.0,1092.5,302.84,2971.6,32
HCPCS,73220,MRI scan of arm before and after contrast,4481.0,2240.5,449.2,6094.16,32
HCPCS,73221,MRI scan of arm joint without contrast,2577.0,1288.5,302.84,3504.72,32
HCPCS,73222,MRI scan of arm joint with contrast,4025.0,2012.5,510.96,5474.0,32
HCPCS,73223,MRI scan of arm joint before and after contrast,4797.0,2398.5,449.2,6523.92,32
HCPCS,73225,MRI scan of blood vessels of arm,4226.0,2113.0,617.13,6850.32,96
HCPCS,73501,"X-ray of hip, 1 view",328.0,164.0,29.15,446.08,32
HCPCS,73502,"X-ray of hip, 2-3 views",374.0,187.0,37.0,508.64,32
HCPCS,73503,"X-ray of hip, minimum of 4 views",546.0,273.0,37.0,742.56,32
HCPCS,73521,"X-ray of both hips, 2 views",561.0,280.5,41.49,762.96,32
HCPCS,73522,"X-ray of both hips, 3-4 views",604.0,302.0,41.49,821.44,32
HCPCS,73523,"X-ray of both hips, minimum of 5 views",823.0,411.5,41.49,1119.28,32
HCPCS,73525,Review by radiologist of hip joint image,1117.0,558.5,131.2,1519.12,32
HCPCS,73551,"X-ray of thigh bone, 1 view",339.0,169.5,35.7,461.04,32
HCPCS,73552,"X-ray of thigh bone, minimum 2 views",367.0,183.5,35.89,499.12,32
HCPCS,73560,"X-ray of knee, 1-2 views",384.0,192.0,32.53,522.24,32
HCPCS,73562,"X-ray of knee, 3 views",604.0,302.0,35.89,821.44,32
HCPCS,73564,"X-ray of knee, 4 or more views",693.0,346.5,39.25,942.48,32
HCPCS,73565,X-ray of both knees while standing,430.0,215.0,31.39,584.8,32
HCPCS,73590,"X-ray of lower leg, 2 views",450.0,225.0,32.53,612.0,32
HCPCS,73592,"X-ray of infant leg, minimum of 2 views",267.0,133.5,31.39,363.12,32
HCPCS,73600,"X-ray of ankle, 2 views",360.0,180.0,31.39,489.6,32
HCPCS,73610,"X-ray of ankle, minimum of 3 views",480.0,240.0,32.53,652.8,32
HCPCS,73620,"X-ray of foot, 2 views",351.0,175.5,31.39,477.36,32
HCPCS,73630,"X-ray of foot, minimum of 3 views",632.0,316.0,32.53,859.52,32
HCPCS,73650,"X-ray of heel, minimum of 2 views",293.0,146.5,30.28,398.48,32
HCPCS,73660,"X-ray of toe, minimum of 2 views",437.0,218.5,25.79,594.32,32
HCPCS,73700,CT scan of leg without contrast,2187.0,1093.5,133.94,2974.32,32
HCPCS,73701,CT scan of leg with contrast material,2489.0,1244.5,225.85,3385.04,32
HCPCS,73702,CT scan of leg before and after contrast,2990.0,1495.0,225.85,4066.4,32
HCPCS,73706,CT scan of blood vessels of lower leg with contrast,3364.0,1682.0,225.85,4575.04,32
HCPCS,73718,MRI scan of leg without contrast,2824.0,1412.0,302.84,3840.64,32
HCPCS,73720,MRI scan of leg before and after contrast,4166.0,2083.0,449.2,5665.76,32
HCPCS,73721,MRI scan of leg joint without contrast,2594.0,1297.0,302.84,3527.84,32
HCPCS,73722,MRI scan of leg joint with contrast,3715.0,1857.5,510.96,5052.4,32
HCPCS,73723,MRI scan of leg joint before and after contrast,4238.0,2119.0,449.2,5763.68,32
HCPCS,73725,MRI scan of blood vessels of leg,3901.0,1950.5,617.13,6052.0,128
HCPCS,74018,"X-ray of abdomen, 1 view",516.0,258.0,31.57,701.76,32
HCPCS,74019,"X-ray of abdomen, 2 views",534.0,267.0,34.84,726.24,32
HCPCS,74021,"X-ray of abdomen, minimum of 3 views",592.0,296.0,39.25,805.12,32
HCPCS,74022,X-ray series of abdomen with single X-ray of chest,600.0,300.0,47.09,816.0,32
HCPCS,74150,CT scan of abdomen without contrast,2065.0,1032.5,133.94,2808.4,32
HCPCS,74160,CT scan of abdomen with contrast,2749.0,1374.5,225.85,3738.64,32
HCPCS,74170,CT scan of abdomen before and after contrast,3209.0,1604.5,225.85,4364.24,32
HCPCS,74174,CT scan of blood vessels of abdomen and pelvis with contrast,5024.0,2512.0,425.0,6832.64,32
HCPCS,74175,CT scan of blood vessels of abdomen with contrast,4319.0,2159.5,225.85,5873.84,32
HCPCS,74176,CT scan of abdomen and pelvis without contrast,5799.0,2899.5,307.22,7886.64,32
HCPCS,74177,CT scan of abdomen and pelvis with contrast,6486.0,3243.0,381.53,8820.96,32
HCPCS,74178,CT scan of abdomen and pelvis before and after contrast,8162.0,4081.0,381.53,11100.32,32
HCPCS,74181,MRI scan of abdomen without contrast,3090.0,1545.0,302.84,4202.4,32
HCPCS,74183,MRI scan of abdomen before and after contrast,4285.0,2142.5,449.2,5827.6,32
HCPCS,74185,MRI scan of blood vessels of abdomen,4034.0,2017.0,617.13,6118.64,96
HCPCS,74220,Single contrast X-ray of esophagus,481.0,240.5,70.48,654.16,32
HCPCS,74221,Double contrast X-ray of esophagus,606.0,303.0,71.86,824.16,32
HCPCS,74230,Imaging for evaluation of swallowing function,566.0,283.0,80.74,769.76,32
HCPCS,74240,Single contrast X-ray of upper digestive tract,538.0,269.0,90.83,731.68,32
HCPCS,74246,Double contrast X-ray of upper digestive tract,1035.0,517.5,103.16,1407.6,32
HCPCS,74248,Follow-through X-ray of small intestines,681.0,340.5,50.84,926.16,32
HCPCS,74250,Single contrast X-ray of small intestine,592.0,296.0,80.74,805.12,32
HCPCS,74261,Diagnostic CT scan of large intestine without contrast,1311.0,655.5,133.94,1782.96,32
HCPCS,74262,Diagnostic CT scan of large intestine with contrast,1249.0,624.5,225.85,1698.64,32
HCPCS,74263,Screening CT scan of large intestine,1436.0,718.0,133.94,1952.96,32
HCPCS,74270,Single contrast X-ray of large intestine,731.0,365.5,106.53,994.16,32
HCPCS,74280,Double contrast X-ray of large intestine,799.0,399.5,140.17,1086.64,32
HCPCS,74300,Review by radiologist of bile and/or pancreatic duct image during surgery,804.0,402.0,22.42,1093.44,32
HCPCS,74328,Review by radiologist of image from tube placement into bile duct using an endoscope,887.0,443.5,197.36,1206.32,32
HCPCS,74329,Review by radiologist of image from tube placement into pancreatic duct using an endoscope,748.0,374.0,197.36,1017.28,32
HCPCS,74330,Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope,1081.0,540.5,197.36,1470.16,32
HCPCS,74340,Review by radiologist of placement of long small bowel tube,702.0,351.0,164.83,954.72,32
HCPCS,74360,Review by radiologist of image to guide opening of digestive tract,810.0,405.0,196.23,1101.6,32
HCPCS,74420,Imaging of urinary tract following injection of a contrast agent,1000.0,500.0,148.54,1360.0,32
HCPCS,74430,Review by radiologist of urinary bladder image,796.0,398.0,39.6,1082.56,32
HCPCS,74450,Review by radiologist of urinary bladder and urethra images with contrast,882.0,441.0,91.95,1199.52,32
HCPCS,74455,Review by radiologist of urinary bladder and urethra images with contrast and after passing urine,925.0,462.5,98.68,1258.0,32
HCPCS,74712,MRI scan of fetus for single or first pregnancy,3002.0,1501.0,302.84,4082.72,32
HCPCS,74740,Review by radiologist of uterine tube and ovary image,2504.0,1252.0,81.86,3405.44,32
HCPCS,74742,Review by radiologist of image from placement of uterine tube,819.0,409.5,196.23,1113.84,32
HCPCS,75557,MRI scan of heart without contrast,2560.0,1280.0,302.84,3481.6,32
HCPCS,75561,MRI scan of heart before and after contrast,4134.0,2067.0,449.2,5622.24,32
HCPCS,75563,MRI scan of heart before and after contrast with stress imaging,4749.0,2374.5,510.96,6458.64,32
HCPCS,75565,MRI scan of blood flow of heart,4078.0,2039.0,302.84,5546.08,32
HCPCS,75571,CT scan of heart with evaluation of blood vessel calcium,592.0,296.0,28.19,1543.6,96
HCPCS,75572,CT scan of heart structure with contrast,1855.0,927.5,381.53,2522.8,32
HCPCS,75573,CT scan of congenital heart disease with contrast,1770.0,885.0,381.53,2407.2,32
HCPCS,75574,CT scan of blood vessels and grafts of heart with contrast,3036.0,1518.0,449.2,4128.96,32
HCPCS,75580,"Analysis of data from CT study of heart blood vessels to assess severity of heart artery disease, with interpretation and report",4382.0,2191.0,425.0,5959.52,28
HCPCS,75605,Review by radiologist of chest aorta serial images,8453.0,4226.5,151.99,11496.08,32
HCPCS,75625,Review by radiologist of abdominal aorta image,4922.0,2461.0,151.34,6693.92,32
HCPCS,75630,Review by radiologist of abdominal aorta and both leg arteries image,4922.0,2461.0,151.34,6693.92,32
HCPCS,75635,CT scan of abdominal aorta and both leg arteries with contrast,3247.0,1623.5,225.85,4415.92,32
HCPCS,75705,Review by radiologist of spinal artery image,8453.0,4226.5,237.72,11496.08,32
HCPCS,75710,Review by radiologist of arm or leg artery image,4922.0,2461.0,197.44,6693.92,32
HCPCS,75716,Review by radiologist of both arms or legs arteries image,5456.0,2728.0,227.29,7420.16,32
HCPCS,75726,Review by radiologist of abdominal artery image,8453.0,4226.5,172.78,11496.08,32
HCPCS,75731,Review by radiologist of adrenal gland artery image,4922.0,2461.0,211.73,6693.92,32
HCPCS,75736,Review by radiologist of pelvis artery image,8453.0,4226.5,194.18,11496.08,64
HCPCS,75741,Review by radiologist of lung artery image,4922.0,2461.0,161.09,6693.92,32
HCPCS,75743,Review by radiologist of arteries of both lungs image,5089.0,2544.5,163.03,6921.04,32
HCPCS,75746,Review by radiologist of lung artery image with contrast,4922.0,2461.0,176.65,6693.92,32
HCPCS,75756,Review by radiologist of breast artery of breast image,4922.0,2461.0,204.58,6693.92,32
HCPCS,75774,Review by radiologist of additional artery image,2139.0,1069.5,641.7,5880.39,32
HCPCS,75805,Review by radiologist of lymphatic system of side of pelvis and abdomen image,3344.0,1672.0,380.13,4547.84,32
HCPCS,75807,Review by radiologist of lymphatic system of both side of pelvis and abdomen image,3623.0,1811.5,381.25,4927.28,32
HCPCS,75809,Review by radiologist of previous placed shunt image,645.0,322.5,49.33,877.2,32
HCPCS,75810,Review by radiologist of spleen and liver vein image,4922.0,2461.0,784.93,6693.92,32
HCPCS,75820,Review by radiologist of 1 arm or leg vein of 1 arm or leg image,2429.0,1214.5,59.43,3303.44,32
HCPCS,75822,Review by radiologist of both arms and legs veins of both arms or legs image,2708.0,1354.0,91.95,3682.88,32
HCPCS,75825,Review by radiologist of major lower body vein image,4922.0,2461.0,146.79,6693.92,32
HCPCS,75827,Review by radiologist of major upper body vein image,3499.0,1749.5,151.34,4758.64,32
HCPCS,75831,Review by radiologist of kidney image,4922.0,2461.0,157.19,6693.92,32
HCPCS,75833,Review by radiologist of both kidneys veins image,4971.0,2485.5,170.15,6760.56,32
HCPCS,75860,Review by radiologist of head or neck vein system image,4922.0,2461.0,160.44,6693.92,64
HCPCS,75870,Review by radiologist of head vein system image,4922.0,2461.0,166.29,6693.92,32
HCPCS,75885,Review by radiologist of the vein that transports blood to the liver image with assessment of blood flow,4971.0,2485.5,163.03,6760.56,32
HCPCS,75887,Review by radiologist of the vein that transports blood to the liver image,4922.0,2461.0,164.34,6693.92,32
HCPCS,75889,Review by radiologist of liver vein image with assessment of blood flow,4971.0,2485.5,163.68,6760.56,32
HCPCS,75891,Review by radiologist of liver vein image,4922.0,2461.0,164.34,6693.92,32
HCPCS,75893,Review by radiologist of imaging guidance for removal of blood sample,8453.0,4226.5,168.23,11496.08,64
HCPCS,75894,Review by radiologist of image for insertion of material to block blood flow,5605.0,2802.5,253.72,7622.8,64
HCPCS,75898,Imaging of blood vessel,4922.0,2461.0,66.16,6693.92,64
HCPCS,75901,Review by radiologist of image for removal of obstructive material,1119.0,559.5,253.72,1521.84,32
HCPCS,75970,Review by radiologist of image for biopsy of blood vessel with tube,3119.0,1559.5,253.72,4241.84,32
HCPCS,75984,Review by radiologist of image for replacement of stomach or large bowel tube,1263.0,631.5,122.23,1717.68,32
HCPCS,75989,Review by radiologist of image for drainage of fluid,2322.0,1161.0,196.23,3157.92,64
HCPCS,76000,"Imaging guidance for procedure, 60 minutes or less",853.0,426.5,70.79,1160.08,64
HCPCS,76010,X-ray from nose to rectum,213.0,106.5,31.15,289.68,32
HCPCS,76080,Review by radiologist of abscess or sinus cavity study,857.0,428.5,53.24,1165.52,64
HCPCS,76098,X-ray of surgical specimen,1034.0,517.0,16.21,1406.24,32
HCPCS,76120,Imaging of organ,302.0,151.0,67.28,410.72,32
HCPCS,76376,3D radiographic procedure,608.0,304.0,182.4,826.88,56
HCPCS,76377,3D radiographic procedure with computerized image postprocessing,651.0,325.5,195.3,885.36,28
HCPCS,76380,Limited or follow-up CT scan,1074.0,537.0,112.05,1460.64,32
HCPCS,76390,MRI study for measuring biochemical changes in the brain,1936.0,968.0,112.05,2632.96,32
HCPCS,76391,MRI and low frequency vibrations for measuring tissue stiffness,2185.0,1092.5,302.84,2971.6,32
HCPCS,76496,Other fluoroscopic procedure,942.0,471.0,70.48,1281.12,32
HCPCS,76499,Other diagnostic Imaging procedure,409.0,204.5,42.12,556.24,32
HCPCS,76506,Ultrasound scan of brain,732.0,366.0,87.46,995.52,32
HCPCS,76510,1D and 2D ultrasound scan of eye tissue and structures,668.0,334.0,137.18,908.48,32
HCPCS,76511,1D ultrasound scan of eye tissue and structures,626.0,313.0,78.49,851.36,32
HCPCS,76512,2D ultrasound scan of eye tissue and structures,576.0,288.0,73.38,783.36,32
HCPCS,76513,Ultrasound scan of eye using water bath method,727.0,363.5,95.32,988.72,32
HCPCS,76519,Ultrasound scan to determine eye length and lens power,464.0,232.0,78.49,631.04,32
HCPCS,76529,Ultrasound scan of eye for foreign body localization,281.0,140.5,70.21,382.16,32
HCPCS,76536,Ultrasound scan of head and neck soft tissue,1238.0,619.0,88.59,1683.68,64
HCPCS,76604,Ultrasound scan of chest,685.0,342.5,81.86,931.6,64
HCPCS,76641,Complete ultrasound scan of 1 breast,1104.0,552.0,66.16,1501.44,32
HCPCS,76642,Limited ultrasound scan of 1 breast,714.0,357.0,66.16,971.04,32
HCPCS,76700,Complete ultrasound scan of abdomen,1500.0,750.0,123.35,2040.0,32
HCPCS,76705,Limited ultrasound scan of abdomen,1063.0,531.5,89.71,1445.68,96
HCPCS,76706,Ultrasound scan of abdominal aorta,582.0,291.0,89.71,791.52,32
HCPCS,76770,Complete ultrasound scan behind abdominal cavity,1172.0,586.0,123.35,1593.92,32
HCPCS,76775,Limited ultrasound scan behind abdominal cavity,864.0,432.0,53.88,1175.04,64
HCPCS,76776,Ultrasound scan of transplanted kidney,1264.0,632.0,134.61,1719.04,32
HCPCS,76800,Ultrasound scan of spinal canal,799.0,399.5,89.71,1086.64,32
HCPCS,76801,"Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus",821.0,410.5,126.37,1116.56,32
HCPCS,76802,"Ultrasound scan of pregnant uterus (less than 14 weeks), each additional fetus",750.0,375.0,106.01,1020.0,32
HCPCS,76805,"Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus",1104.0,552.0,126.37,1501.44,32
HCPCS,76810,"Ultrasound scan of pregnant uterus (14 weeks or more), each additional fetus",984.0,492.0,126.37,1338.24,32
HCPCS,76811,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus",1095.0,547.5,126.37,1489.2,32
HCPCS,76812,"Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, each additional fetus",850.0,425.0,126.37,1156.0,32
HCPCS,76813,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, single or first fetus",811.0,405.5,111.06,1102.96,32
HCPCS,76814,"Ultrasound scan of pregnant uterus (less than 14 weeks), with measurement of the clear space beneath skin at the back of fetal neck, each additional fetus",711.0,355.5,119.27,966.96,32
HCPCS,76815,Limited ultrasound of pregnant uterus,821.0,410.5,88.59,1116.56,96
HCPCS,76816,Follow-up ultrasound scan of pregnant uterus,818.0,409.0,69.52,1112.48,64
HCPCS,76817,Vaginal ultrasound of pregnant uterus,799.0,399.5,109.11,1086.64,64
HCPCS,76818,Ultrasound and monitoring of heart of fetus,1691.0,845.5,100.92,2299.76,64
HCPCS,76819,Ultrasound scan of fetus,1496.0,748.0,90.91,2034.56,64
HCPCS,76820,Ultrasound scan of fetal umbilical artery blood flow rate,791.0,395.5,40.25,1075.76,32
HCPCS,76821,Ultrasound scan of fetal brain artery blood flow rate,899.0,449.5,105.21,1222.64,32
HCPCS,76825,Ultrasound scan of fetal heart,1464.0,732.0,123.35,1991.04,32
HCPCS,76826,Follow-up ultrasound scan of fetal heart,1310.0,655.0,43.74,1781.6,32
HCPCS,76827,Ultrasound scan of fetal heart blood flow,1411.0,705.5,87.03,1918.96,32
HCPCS,76828,Follow-up ultrasound scan of fetal heart blood flow,882.0,441.0,46.74,1199.52,32
HCPCS,76830,"Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina",1028.0,514.0,95.32,1398.08,96
HCPCS,76831,Ultrasound scan of uterus and uterine cavity,1216.0,608.0,150.69,1653.76,32
HCPCS,76856,Complete ultrasound scan of pelvis,1325.0,662.5,95.32,1802.0,32
HCPCS,76857,Limited ultrasound scan of pelvis,980.0,490.0,42.19,1332.8,32
HCPCS,76870,Ultrasound scan of scrotum,1130.0,565.0,65.59,1536.8,32
HCPCS,76872,Ultrasound scan of pelvic region through rectum,1262.0,631.0,95.32,1716.32,32
HCPCS,76881,Complete ultrasound scan of joint,990.0,495.0,134.61,1346.4,32
HCPCS,76882,Limited ultrasound scan of joint or other extremity structure except blood vessels,789.0,394.5,21.4,1073.04,64
HCPCS,76885,Ultrasound scan of infant hip during movement,801.0,400.5,112.05,1089.36,32
HCPCS,76936,Ultrasound guided compression repair of blood vessel,1343.0,671.5,253.72,1826.48,32
HCPCS,76937,Ultrasonic guidance for blood vessel access,715.0,357.5,54.02,972.4,96
HCPCS,76942,Ultrasonic guidance for needle placement,1398.0,699.0,95.32,1901.28,64
HCPCS,76945,Ultrasonic guidance for testing placental tissue,1286.0,643.0,95.32,1748.96,32
HCPCS,76946,Ultrasonic guidance for removal of amniotic fluid,1661.0,830.5,95.32,2258.96,32
HCPCS,76948,Ultrasonic guidance for retrieval of egg,1200.0,600.0,95.32,1632.0,32
HCPCS,76981,Ultrasound scan of organ tissue for measuring elasticity,824.0,412.0,134.61,1120.64,32
HCPCS,76998,Ultrasonic guidance during surgery,1524.0,762.0,141.06,2072.64,32
HCPCS,76999,Other ultrasound procedure,1020.0,510.0,39.84,1387.2,32
HCPCS,77001,Fluoroscopic guidance for insertion or removal of central vein access device,817.0,408.5,144.76,1111.12,32
HCPCS,77002,Fluoroscopic guidance for needle placement,1361.0,680.5,81.86,1850.96,96
HCPCS,77003,Fluoroscopic guidance for spine or back muscle injection,967.0,483.5,83.59,1315.12,96
HCPCS,77012,Review by radiologist of CT guidance for needle placement,2864.0,1432.0,103.38,3895.04,64
HCPCS,77013,CT guidance for tissue removal,3081.0,1540.5,103.38,4190.16,32
HCPCS,77021,Review by radiologist of MRI guidance for needle placement,2763.0,1381.5,273.73,3757.68,32
HCPCS,77046,MRI scan of 1 breast without contrast,2160.0,1080.0,302.84,2937.6,32
HCPCS,77047,MRI scan of both breasts without contrast,3332.0,1666.0,302.84,4531.52,32
HCPCS,77048,MRI scan of 1 breast,3379.0,1689.5,510.96,4595.44,32
HCPCS,77049,MRI scan of both breasts,4500.0,2250.0,510.96,6120.0,32
HCPCS,77061,3D breast mammography of 1 breast,190.0,95.0,59.94,1854.0,64
HCPCS,77062,3D breast mammography of both breasts,226.0,113.0,59.94,1854.0,64
HCPCS,77063,Screening 3D breast mammography,280.0,140.0,23.83,380.8,32
HCPCS,77065,Diagnostic mammography of 1 breast,596.0,298.0,59.94,810.56,32
HCPCS,77066,Diagnostic mammography of both breasts,693.0,346.5,59.94,942.48,32
HCPCS,77067,Screening mammography,621.0,310.5,59.94,844.56,32
HCPCS,77072,X-ray for estimating bone age,625.0,312.5,25.31,850.0,32
HCPCS,77073,X-ray for bone length assessment,289.0,144.5,39.6,393.04,32
HCPCS,77075,Complete X-ray of body bones,945.0,472.5,89.71,1285.2,32
HCPCS,77076,X-ray of infant body bones,413.0,206.5,45.98,561.68,32
HCPCS,77080,"DXA bone density measurement of hip, pelvis, spine",729.0,364.5,57.14,991.44,32
HCPCS,77081,"DXA bone density measurement of forearm, finger, hand, or foot",720.0,360.0,31.8,979.2,32
HCPCS,77085,"DXA bone density measurement of hip, pelvis, spine including spine fracture assessment",947.0,473.5,75.32,1287.92,32
HCPCS,77263,Complex radiation therapy planning,901.0,450.5,150.79,1225.36,32
HCPCS,77280,"Obtaining data needed to develop the optimal radiation treatment, 1 treatment area",2466.0,1233.0,150.79,3353.76,32
HCPCS,77285,"Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas",3319.0,1659.5,234.07,4513.84,32
HCPCS,77290,"Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved",4520.0,2260.0,234.07,6147.2,32
HCPCS,77293,Obtaining respiratory data needed to develop the optimal radiation treatment,3172.0,1586.0,150.79,4313.92,28
HCPCS,77295,3D radiation therapy planning,10195.0,5097.5,496.18,13865.2,32
HCPCS,77300,Calculation of radiation therapy dose,1080.0,540.0,63.63,1468.8,96
HCPCS,77301,High precision radiation therapy planning,15180.0,7590.0,1335.85,20644.8,32
HCPCS,77306,Simple radiation therapy planning for delivery of external radiation,4116.0,2058.0,142.21,5597.76,32
HCPCS,77307,Complex radiation therapy planning for delivery of external radiation,5189.0,2594.5,167.08,7057.04,32
HCPCS,77316,Simple radiation therapy planning for delivery of internal radiation,1494.0,747.0,146.89,2031.84,32
HCPCS,77317,Intermediate radiation therapy planning for delivery of internal radiation,2035.0,1017.5,216.42,2767.6,32
HCPCS,77321,Special radiation therapy planning for delivery of external radiation,2248.0,1124.0,80.52,3057.28,32
HCPCS,77331,Special radiation therapy planning,1126.0,563.0,31.39,1531.36,32
HCPCS,77332,Design and construction of simple radiation treatment device,1111.0,555.5,84.1,1510.96,32
HCPCS,77333,Design and construction of intermediate radiation treatment device,1552.0,776.0,18.17,2110.72,32
HCPCS,77334,Design and construction of complex radiation treatment device,2694.0,1347.0,163.03,3663.84,32
HCPCS,77336,Continuing radiation therapy consultation per week,1175.0,587.5,88.11,1598.0,32
HCPCS,77338,Design and construction of radiation treatment device for high precision radiation therapy,3566.0,1783.0,234.07,4849.76,32
HCPCS,77370,Special medical radiation therapy consultation,1224.0,612.0,114.37,1664.64,32
HCPCS,77372,Complete single session course of cranial lesion surgery using radiation and a machine to deliver external radiation,30831.0,15415.5,1109.1,41930.16,32
HCPCS,77373,Delivery of radiation therapy per dose to 1 or more lesions not to exceed 5 doses,16011.0,8005.5,1785.79,21774.96,32
HCPCS,77387,Imaging guidance for localization of radiation treatment,1930.0,965.0,71.44,2624.8,32
HCPCS,77402,Delivery of simple radiation treatment,989.0,494.5,66.43,1345.04,32
HCPCS,77417,X-ray during radiation therapy,599.0,299.5,25.53,814.64,32
HCPCS,77470,Special radiation treatment,4044.0,2022.0,89.58,5499.84,64
HCPCS,77750,Infusion or instillation of radioelement solution,826.0,413.0,82.98,1123.36,32
HCPCS,77763,Complex body cavity radiation source application,4034.0,2017.0,279.21,5486.24,32
HCPCS,77770,"High dose radiation therapy, 1 channel",3237.0,1618.5,405.91,4402.32,64
HCPCS,77771,"High dose radiation therapy, 2-12 channels",5683.0,2841.5,739.1,7728.88,64
HCPCS,77772,"High dose radiation therapy, more than 12 channels",9009.0,4504.5,837.0,12252.24,32
HCPCS,77778,Complex application of radiation source,5668.0,2834.0,320.7,7708.48,32
HCPCS,78014,Nuclear medicine study of thyroid and thyroid function,3258.0,1629.0,161.47,4430.88,32
HCPCS,78018,Nuclear medicine study of whole body for thyroid cancer,3101.0,1550.5,338.64,4217.36,32
HCPCS,78070,Nuclear medicine study of parathyroid,2189.0,1094.5,113.26,2977.04,32
HCPCS,78072,Nuclear medicine study of parathyroid with SPECT and CT scan,6542.0,3271.0,113.26,8897.12,32
HCPCS,78102,Nuclear medicine study of bone marrow limited area,1331.0,665.5,126.71,1810.16,32
HCPCS,78111,"Nuclear medicine study of plasma volume, multiple samplings",4500.0,2250.0,160.36,6120.0,32
HCPCS,78121,"Nuclear medicine study of red blood cell volume, multiple samples",1605.0,802.5,164.92,2182.8,32
HCPCS,78195,Nuclear medicine study of lymphatic system,3039.0,1519.5,254.54,4133.04,32
HCPCS,78215,Nuclear medicine study of liver and spleen,1506.0,753.0,182.78,2048.16,32
HCPCS,78226,Nuclear medicine study of liver and bile duct system,2198.0,1099.0,461.21,2989.28,32
HCPCS,78227,Nuclear medicine study of liver and bile duct system with use of drugs,2475.0,1237.5,461.21,3366.0,32
HCPCS,78264,Nuclear medicine study of stomach to assess emptying,1961.0,980.5,256.79,2666.96,32
HCPCS,78278,Nuclear medicine study to assess blood loss,1745.0,872.5,303.89,2373.2,32
HCPCS,78290,Nuclear medicine study of intestine,3189.0,1594.5,189.5,4337.04,32
HCPCS,78291,Nuclear medicine study to assess the degree of openness of shunt from jugular vein to abdominal cavity,986.0,493.0,191.75,1340.96,32
HCPCS,78300,Nuclear medicine study of bone and/or joint limited area,1307.0,653.5,155.87,1777.52,32
HCPCS,78306,Nuclear medicine study of bone and/or joint whole body,2310.0,1155.0,266.87,3141.6,32
HCPCS,78315,Nuclear medicine study of bone taken at different times,3015.0,1507.5,298.28,4100.4,32
HCPCS,78430,Nuclear medicine study of blood flow in heart muscle at rest and with stress with concurrent CT scan,5827.0,2913.5,1575.0,7924.72,32
HCPCS,78431,Nuclear medicine studies of blood flow in heart muscle at rest and with stress with concurrent CT scan,6651.0,3325.5,1575.0,9045.36,31
HCPCS,78433,Nuclear medicine study of heart muscle with metabolic and blood flow evaluation requiring 2 injections and concurrent CT scan,10514.0,5257.0,1575.0,14299.04,31
HCPCS,78434,Nuclear medicine study of heart muscle blood flow by PET,2890.0,1445.0,924.8,3930.4,32
HCPCS,78451,Nuclear medicine study of heart muscle at rest and with stress and SPECT,3553.0,1776.5,524.16,4832.08,32
HCPCS,78452,Nuclear medicine studies of heart muscle at rest and with stress and SPECT,5447.0,2723.5,752.78,7407.92,32
HCPCS,78459,Nuclear medicine study of heart muscle with metabolic evaluation,6346.0,3173.0,1575.0,8630.56,32
HCPCS,78472,Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles,2391.0,1195.5,344.25,3251.76,32
HCPCS,78579,Nuclear medicine study of lung ventilation,839.0,419.5,310.61,1170.94,32
HCPCS,78580,Nuclear medicine study of lung circulation,1434.0,717.0,214.17,1950.24,32
HCPCS,78582,Nuclear medicine study of lung ventilation and circulation,1947.0,973.5,350.98,2647.92,32
HCPCS,78598,Nuclear medicine study of lung ventilation and circulation and blood flow to lung,2020.0,1010.0,440.68,2747.2,32
HCPCS,78601,Nuclear medicine study of brain and blood flow,1162.0,581.0,211.93,1580.32,32
HCPCS,78608,Nuclear medicine study of brain with metabolic evaluation,6318.0,3159.0,220.91,8592.48,32
HCPCS,78707,"Nuclear medicine study of kidney, blood flow, and function",1778.0,889.0,279.21,2418.08,32
HCPCS,78708,"Nuclear medicine study of kidney, blood, flow, and function with drug administration",2763.0,1381.5,222.06,3757.68,32
HCPCS,78725,Nuclear medicine study of kidney function,691.0,345.5,112.13,939.76,32
HCPCS,78800,"Nuclear medicine study, 1 area",932.0,466.0,211.93,1267.52,32
HCPCS,78801,"Nuclear medicine study, multiple areas",2289.0,1144.5,263.52,3113.04,32
HCPCS,78802,"Nuclear medicine study, whole body",3515.0,1757.5,345.36,4780.4,32
HCPCS,78803,"Nuclear medicine study, SPECT imaging, 1 area or single acquisition, single day imaging",3556.0,1778.0,408.16,4836.16,32
HCPCS,78804,"Nuclear medicine study, whole body requiring multiple imaging days",4258.0,2129.0,699.13,5790.88,32
HCPCS,78814,Nuclear medicine study limited area with CT scan,6542.0,3271.0,1575.0,8897.12,32
HCPCS,78815,Nuclear medicine study from skull base to mid-thigh with CT scan,8389.0,4194.5,1575.0,11409.04,32
HCPCS,78816,Nuclear medicine study whole body with CT scan,9500.0,4750.0,1575.0,12920.0,32
HCPCS,78830,"Nuclear medicine study, SPECT imaging with concurrent CT scan, 1 area or single acquisition, single day imaging",3897.0,1948.5,570.12,5299.92,64
HCPCS,78832,"Nuclear medicine study, SPECT imaging with concurrent CT scan, at least 2 areas or separate acquisitions, single day imaging, or single area or acquisition over multiple days",6283.0,3141.5,837.0,8544.88,64
HCPCS,78835,Quantification of radioactive materials,2015.0,1007.5,461.21,2740.4,32
HCPCS,79005,Radioactive drug therapy by mouth,1932.0,966.0,91.54,2627.52,32
HCPCS,79101,Radioactive drug therapy through a vein,2063.0,1031.5,88.32,2805.68,32
HCPCS,79445,Radioactive drug therapy through a tube inserted in an artery,1716.0,858.0,182.11,2333.76,32
HCPCS,80047,"Blood test, basic group of blood chemicals (Calcium, ionized)",186.0,93.0,9.19,252.96,32
HCPCS,80048,"Blood test, basic group of blood chemicals (Calcium, total)",120.0,60.0,9.19,163.2,32
HCPCS,80050,General health panel,446.0,223.0,9.19,606.56,32
HCPCS,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",86.0,43.0,6.03,116.96,32
HCPCS,80053,"Blood test, comprehensive group of blood chemicals",245.0,122.5,9.19,333.2,32
HCPCS,80061,"Blood test, lipids (cholesterol and triglycerides)",169.0,84.5,9.19,229.84,32
HCPCS,80069,Kidney function blood test panel,147.0,73.5,9.19,199.92,32
HCPCS,80074,Acute hepatitis panel,510.0,255.0,9.19,693.6,32
HCPCS,80076,Liver function blood test panel,140.0,70.0,9.19,190.4,32
HCPCS,80143,Measurement of acetaminophen,190.0,95.0,12.35,258.4,32
HCPCS,80145,Measurement of adalimumab,412.0,206.0,12.35,739.84,64
HCPCS,80150,Amikacin (antibiotic) level,94.0,47.0,12.35,127.84,32
HCPCS,80156,"Carbamazepine level, total",153.0,76.5,12.35,208.08,32
HCPCS,80158,Cyclosporine level,219.0,109.5,12.35,297.84,32
HCPCS,80159,Clozapine level,121.0,60.5,12.35,164.56,32
HCPCS,80161,"Measurement of carbamazepine-10,11-epoxide",188.0,94.0,12.35,255.68,32
HCPCS,80162,"Digoxin level, total",113.0,56.5,12.35,153.68,32
HCPCS,80164,"Valproic acid level, total",118.0,59.0,12.35,160.48,32
HCPCS,80165,"Valproic acid level, free",300.0,150.0,12.35,408.0,32
HCPCS,80167,Measurement of felbamate,430.0,215.0,12.35,584.8,32
HCPCS,80168,Ethosuximide level,67.0,33.5,10.95,91.12,32
HCPCS,80169,Everolimus level,224.0,112.0,12.35,304.64,32
HCPCS,80170,Gentamicin (antibiotic) level,139.0,69.5,12.35,189.04,32
HCPCS,80171,Gabapentin level,173.0,86.5,12.35,235.28,32
HCPCS,80175,Lamotrigine level,193.0,96.5,12.35,262.48,32
HCPCS,80176,Lidocaine level,60.0,30.0,8.81,81.6,32
HCPCS,80177,Levetiracetam level,193.0,96.5,12.35,262.48,32
HCPCS,80178,Lithium level,69.0,34.5,4.56,93.84,32
HCPCS,80179,Measurement of salicylate,167.0,83.5,12.35,227.12,32
HCPCS,80180,Mycophenolate (mycophenolic acid) level,40.0,20.0,7.22,64.98,32
HCPCS,80183,Oxcarbazepine level,193.0,96.5,12.35,262.48,32
HCPCS,80184,Phenobarbital level,98.0,49.0,12.35,133.28,32
HCPCS,80185,"Phenytoin level, total",146.0,73.0,12.35,198.56,32
HCPCS,80186,"Phenytoin level, free",155.0,77.5,12.35,210.8,32
HCPCS,80188,Primidone level,104.0,52.0,12.35,141.44,32
HCPCS,80189,Measurement of itraconazole,415.0,207.5,12.35,564.4,32
HCPCS,80193,Measurement of leflunomide,307.0,153.5,12.35,417.52,32
HCPCS,80195,Sirolimus level,164.0,82.0,12.35,223.04,32
HCPCS,80197,Tacrolimus level,251.0,125.5,12.35,341.36,32
HCPCS,80198,Theophylline level,52.0,26.0,7.35,70.72,32
HCPCS,80200,Tobramycin (antibiotic) level,107.0,53.5,12.35,145.52,32
HCPCS,80201,Topiramate level,44.0,22.0,5.24,59.84,32
HCPCS,80202,Vancomycin (antibiotic) level,128.0,64.0,12.35,174.08,32
HCPCS,80203,Zonisamide level,193.0,96.5,12.35,262.48,32
HCPCS,80204,Measurement of methotrexate,200.0,100.0,12.35,272.0,32
HCPCS,80220,Measurement of hydroxychloroquine,64.0,32.0,11.93,87.04,32
HCPCS,80230,Measurement of infliximab,544.0,272.0,12.35,739.84,32
HCPCS,80235,Measurement of lacosamide,109.0,54.5,12.35,148.24,32
HCPCS,80280,Measurement of vedolizumab,421.0,210.5,12.35,572.56,32
HCPCS,80285,Measurement of voriconazole,109.0,54.5,12.35,148.24,32
HCPCS,80299,Quantitation of therapeutic drug,250.0,125.0,12.35,380.8,64
HCPCS,80305,"Testing for presence of drug, read by direct observation",356.0,178.0,14.24,484.16,32
HCPCS,80307,"Testing for presence of drug, by chemistry analyzers",263.0,131.5,71.02,357.68,256
HCPCS,80320,Alcohols levels,165.0,82.5,14.24,224.4,30
HCPCS,80321,"Alcohols levels, 1 or 2",412.0,206.0,14.24,560.32,30
HCPCS,80323,Alkaloids levels,62.0,31.0,14.24,84.32,30
HCPCS,80335,"Antidepressants levels, 1 or 2 (tricyclic and other cyclicals)",51.0,25.5,14.24,69.36,120
HCPCS,80339,"Antiepileptics levels, 1-3",218.0,109.0,17.32,296.48,30
HCPCS,80346,"Benzodiazepines levels, 1-12",56.0,28.0,14.24,76.16,60
HCPCS,80349,"Cannabinoids levels, natural",101.0,50.5,14.24,137.36,30
HCPCS,80354,Fentanyl level,419.0,209.5,14.24,569.84,30
HCPCS,80356,Heroin metabolite level,123.0,61.5,14.24,167.28,30
HCPCS,80361,Opiates levels,175.0,87.5,14.24,238.0,30
HCPCS,80365,Oxycodone levels,175.0,87.5,14.24,238.0,30
HCPCS,80375,"Drugs or substances measurement, 1-3",80.0,40.0,24.0,108.8,30
HCPCS,80377,"Drugs or substances measurement, 7 or more",275.0,137.5,14.24,374.0,30
HCPCS,80408,Aldosterone suppression evaluation panel,440.0,220.0,35.6,598.4,32
HCPCS,81001,"Manual urinalysis test with examination using microscope, automated",68.0,34.0,2.16,92.48,32
HCPCS,81002,"Urinalysis, manual test",43.0,21.5,1.5,58.48,64
HCPCS,81003,Automated urinalysis test,42.0,21.0,0.95,57.12,64
HCPCS,81015,Urinalysis using microscope,43.0,21.5,1.31,58.48,32
HCPCS,81025,Urine pregnancy test,87.0,43.5,3.06,118.32,64
HCPCS,81050,Urine volume measurement,35.0,17.5,1.27,47.6,32
HCPCS,81105,Gene analysis (Human Platelet Antigen 1) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81106,Gene analysis (Human Platelet Antigen 2) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81107,Gene analysis (Human Platelet Antigen 3) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81108,Gene analysis (Human Platelet Antigen 4) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81109,Gene analysis (Human Platelet Antigen 5) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81110,Gene analysis (Human Platelet Antigen 6) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81111,Gene analysis (Human Platelet Antigen 9) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81112,Gene analysis (Human Platelet Antigen 15) for common variant,359.0,179.5,47.41,488.24,32
HCPCS,81120,"Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants",697.0,348.5,167.65,1346.95,32
HCPCS,81121,"Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common variants",783.0,391.5,167.65,2316.04,32
HCPCS,81162,Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants,4500.0,2250.0,1440.0,82119.6,32
HCPCS,81170,"Gene analysis (ABL proto-oncogene 1, non-receptor tyrosine kinase)",1116.0,558.0,167.65,3348.0,32
HCPCS,81206,Translocation analysis (BCR/ABL1) major breakpoint,825.0,412.5,167.65,1352.67,32
HCPCS,81207,Translocation analysis (BCR/ABL1) minor breakpoint,819.0,409.5,167.65,1186.24,32
HCPCS,81210,Gene analysis (v-raf murine sarcoma viral oncogene homolog B1),632.0,316.0,167.65,1108.53,32
HCPCS,81219,"Gene analysis (calreticulin), common variants",701.0,350.5,47.41,953.36,32
HCPCS,81220,Gene analysis (cystic fibrosis transmembrane conductance regular) common variants,2004.0,1002.0,341.64,11154.26,32
HCPCS,81223,Gene analysis (cystic fibrosis transmembrane conductance regular) full gene sequence,1722.0,861.0,365.76,8592.78,32
HCPCS,81225,"Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants",863.0,431.5,167.65,2514.44,32
HCPCS,81229,Genome-wide microarray analysis for copy number and single nucleotide polymorphism (SNP) variants,4669.0,2334.5,848.51,54160.4,32
HCPCS,81232,Gene analysis (dihydropyrimidine dehydrogenase) for common variant,612.0,306.0,167.65,1069.84,32
HCPCS,81240,"Gene analysis (prothrombin, coagulation factor II) A variant",692.0,346.0,47.41,941.12,32
HCPCS,81241,Gene analysis (coagulation factor V) Leiden variant,539.0,269.5,47.41,733.04,32
HCPCS,81243,"Gene analysis (fragile X syndrome, X-linked intellectual disability) for detection of abnormal alleles",555.0,277.5,47.41,754.8,32
HCPCS,81245,Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication variants,749.0,374.5,167.65,1239.67,32
HCPCS,81246,Test for detecting genes associated with blood cancer,300.0,150.0,47.41,408.0,32
HCPCS,81249,Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis,2070.0,1035.0,621.0,12420.0,32
HCPCS,81256,Gene analysis (hemochromatosis) common variants,316.0,158.0,47.41,429.76,32
HCPCS,81257,Gene analysis (alpha globin 1 and alpha globin 2) for common deletions or variant,1027.0,513.5,47.41,1396.72,32
HCPCS,81261,Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect abnormal clonal population amplified methodology,973.0,486.5,167.65,1926.44,32
HCPCS,81263,"Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region somatic mutation analysis",806.0,403.0,167.65,2373.83,32
HCPCS,81264,Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect abnormal clonal population,696.0,348.0,167.65,1202.2,32
HCPCS,81265,Comparative analysis using Short Tandem Repeat (STR) markers of patient and specimen,1337.0,668.5,167.65,3116.15,32
HCPCS,81267,"Chimerism analysis post transplantation, without cell selection",1154.0,577.0,167.65,2394.09,32
HCPCS,81268,"Chimerism analysis post transplantation, with cell selection",967.0,483.5,167.65,2521.84,32
HCPCS,81269,Gene analysis (alpha globin 1 and alpha globin 2) for duplication/deletion variants,699.0,349.5,167.65,1414.78,32
HCPCS,81270,Gene analysis (Janus kinase 2) variant,863.0,431.5,47.41,1173.68,32
HCPCS,81273,"Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), D816 variants",839.0,419.5,47.41,1141.04,32
HCPCS,81275,Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13,852.0,426.0,167.65,1646.49,32
HCPCS,81276,"Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants",483.0,241.5,154.56,933.4,32
HCPCS,81278,Gene analysis (IGH@/BCL2 (t(14;18)) translocation analysis,759.0,379.5,167.65,1573.48,32
HCPCS,81279,Gene analysis (Janus kinase 2) targeted sequence analysis,802.0,401.0,167.65,1485.3,32
HCPCS,81291,"Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants",406.0,203.0,47.41,552.16,32
HCPCS,81301,Microsatellite instability analysis,796.0,398.0,167.65,2774.54,32
HCPCS,81305,Gene analysis (myeloid differentiation primary response 88) for p.Leu265Pro variant,895.0,447.5,167.65,1569.83,32
HCPCS,81310,Gene analysis (nucleophosmin) exon 12 variants,888.0,444.0,167.65,2189.1,32
HCPCS,81311,Gene analysis for cancer (neuroblastoma),1006.0,503.0,167.65,2975.65,32
HCPCS,81315,Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint,662.0,331.0,167.65,1372.39,32
HCPCS,81329,"Gene analysis (survival of motor neuron 1, telomeric) for dosage/deletion",494.0,247.0,148.2,676.78,32
HCPCS,81335,Gene analysis (thiopurine S-methyltransferase) for common variant,648.0,324.0,167.65,1132.77,32
HCPCS,81338,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) for detection of common variants",519.0,259.5,155.7,780.21,32
HCPCS,81339,"Gene analysis (MPL proto-oncogene, thrombopoietin receptor) sequence analysis of exon 10",636.0,318.0,167.65,1177.87,32
HCPCS,81340,Gene analysis (T cell antigen receptor beta) amplification methodology,2231.0,1115.5,167.65,4661.01,32
HCPCS,81342,Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma),651.0,325.5,167.65,1311.77,32
HCPCS,81352,Gene analysis (tumor protein 53) targeted sequence analysis,2025.0,1012.5,167.65,6672.58,32
HCPCS,81364,"Gene analysis (hemoglobin, subunit beta) full sequence analysis",1745.0,872.5,167.65,5663.92,32
HCPCS,81370,"HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1",1491.0,745.5,365.76,5995.61,32
HCPCS,81372,HLA class I typing low resolution,1019.0,509.5,326.08,4112.58,32
HCPCS,81373,HLA class I typing low resolution one locus,933.0,466.5,47.41,1268.88,32
HCPCS,81374,"HLA class I typing, low resolution one antigen equivalent",829.0,414.5,47.41,1127.44,32
HCPCS,81376,HLA class II typing low resolution one locus,884.0,442.0,47.41,1202.24,32
HCPCS,81377,HLA class II typing low resolution one antigen equivalent,933.0,466.5,47.41,1268.88,32
HCPCS,81378,"HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1",1281.0,640.5,167.65,4426.75,32
HCPCS,81380,HLA class I typing high resolution one locus,812.0,406.0,167.65,1439.27,32
HCPCS,81381,HLA class I typing high resolution one allele or allele group,518.0,259.0,165.76,880.08,32
HCPCS,81382,HLA class II typing high resolution one locus,632.0,316.0,47.41,859.52,32
HCPCS,81401,Molecular pathology procedure level 2,889.0,444.5,159.62,1217.93,160
HCPCS,81403,Molecular pathology procedure level 4 genetic analysis,1238.0,619.0,167.65,2292.78,128
HCPCS,81404,Molecular pathology procedure level 5 genetic analysis,1476.0,738.0,167.65,4056.49,32
HCPCS,81406,Molecular pathology procedure level 7 genetic analysis,4144.0,2072.0,167.65,11722.55,32
HCPCS,81408,Molecular pathology procedure level 9 genetic analysis,4600.0,2300.0,821.94,92000.0,32
HCPCS,81420,"Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel",2734.0,1367.0,667.43,20752.43,32
HCPCS,81443,Genomic sequence analysis panel for severe inherited conditions with sequencing of 15 or more genes,2853.0,1426.5,855.9,69857.42,32
HCPCS,81450,Genomic sequence analysis panel of DNA or combined DNA and RNA of 5-50 genes associated with blood and lymphatic system disorders,3134.0,1567.0,667.43,23803.67,64
HCPCS,81479,Molecular pathology procedure,455.0,227.5,0.5,671.84,192
HCPCS,81514,Measurement of DNA of bacteria in vaginal fluid specimen,395.0,197.5,118.5,1038.81,32
HCPCS,81596,Biochemical assays for evaluation of chronic Hepatitis C virus infection,291.0,145.5,47.41,395.76,32
HCPCS,82010,"Ketone bodies analysis, quantitative",137.0,68.5,5.5,186.32,64
HCPCS,82017,Chemical test for genetic disorder,69.0,34.5,11.64,93.84,32
HCPCS,82024,Adrenocorticotropic hormone (ACTH) level,140.0,70.0,35.6,190.4,32
HCPCS,82040,Albumin (protein) level,49.0,24.5,2.43,66.64,32
HCPCS,82042,"Cerebrospinal fluid, or amniotic fluid albumin (protein) level",29.0,14.5,2.26,39.44,32
HCPCS,82043,Urine microalbumin (protein) level,94.0,47.0,3.06,127.84,32
HCPCS,82077,Measurement of alcohol level in specimen other than breath or urine,154.0,77.0,14.24,209.44,32
HCPCS,82085,Aldolase (enzyme) level,35.0,17.5,3.4,47.6,32
HCPCS,82088,Aldosterone hormone level,148.0,74.0,35.6,201.28,32
HCPCS,82103,"Alpha-1-antitrypsin (protein) blood test, total",56.0,28.0,7.53,76.16,32
HCPCS,82104,"Alpha-1-antitrypsin (protein) blood test, phenotype",180.0,90.0,12.17,244.8,32
HCPCS,82105,"Alpha-fetoprotein (AFP) level, serum",161.0,80.5,12.17,218.96,32
HCPCS,82106,"Alpha-fetoprotein (AFP) level, amniotic fluid",62.0,31.0,10.54,84.32,32
HCPCS,82107,Alpha-fetoprotein (AFP) analysis,293.0,146.5,28.66,398.48,32
HCPCS,82108,Aluminum level,99.0,49.5,12.53,134.64,32
HCPCS,82131,"Amino acid analysis, quantitative, each specimen",344.0,172.0,12.17,467.84,32
HCPCS,82139,"Amino acid level, 6 or more amino acids, quantitative, each specimen",821.0,410.5,12.17,1116.56,32
HCPCS,82140,Ammonia level,54.0,27.0,7.87,73.44,32
HCPCS,82150,Amylase (enzyme) level,99.0,49.5,5.5,134.64,32
HCPCS,82157,Androstenedione (hormone) level,106.0,53.0,13.43,144.16,32
HCPCS,82164,Angiotensin l - converting enzyme (ACE) level,54.0,27.0,7.88,73.44,32
HCPCS,82166,Test for anti-mullerian hormone,281.0,140.5,84.3,382.16,28
HCPCS,82172,Apolipoprotein level,77.0,38.5,12.17,104.72,64
HCPCS,82175,Arsenic level,113.0,56.5,12.53,153.68,32
HCPCS,82180,"Ascorbic acid (Vitamin C) level, blood",138.0,69.0,5.5,187.68,32
HCPCS,82232,Beta-2 microglobulin (protein) level,135.0,67.5,13.43,183.6,32
HCPCS,82239,"Bile acids level, total",66.0,33.0,11.3,89.76,32
HCPCS,82247,"Bilirubin level, total",49.0,24.5,2.46,66.64,32
HCPCS,82248,"Bilirubin level, direct",49.0,24.5,2.46,66.64,32
HCPCS,82261,Biotinidase (enzyme) level,62.0,31.0,10.46,84.32,32
HCPCS,82270,Stool analysis for blood to screen for colon tumors,43.0,21.5,1.88,58.48,32
HCPCS,82272,"Stool analysis for blood, by peroxidase activity",51.0,25.5,2.16,69.36,32
HCPCS,82300,Cadmium level,142.0,71.0,12.53,193.12,32
HCPCS,82306,Vitamin D-3 level,160.0,80.0,28.66,217.6,32
HCPCS,82308,Calcitonin (hormone) level,108.0,54.0,13.43,146.88,32
HCPCS,82310,"Calcium level, total",63.0,31.5,3.25,85.68,32
HCPCS,82330,"Calcium level, ionized",80.0,40.0,10.94,108.8,32
HCPCS,82340,Urine calcium level,68.0,34.0,4.1,92.48,32
HCPCS,82365,Infrared analysis of stone,47.0,23.5,6.06,63.92,32
HCPCS,82373,Carbohydrate deficient transferrin (protein) level,66.0,33.0,11.92,89.76,32
HCPCS,82374,Carbon dioxide (bicarbonate) level,49.0,24.5,2.39,66.64,32
HCPCS,82375,Carboxyhemoglobin (protein) level,50.0,25.0,6.16,68.0,32
HCPCS,82378,Carcinoembryonic antigen (CEA) protein level,206.0,103.0,12.17,280.16,32
HCPCS,82379,Carnitine level,62.0,31.0,10.46,84.32,32
HCPCS,82380,Carotene level,83.0,41.5,5.5,112.88,32
HCPCS,82384,Catecholamines (organic nitrogen) level,92.0,46.0,13.43,125.12,32
HCPCS,82390,Ceruloplasmin (protein) level,40.0,20.0,4.3,54.4,32
HCPCS,82397,Analysis using chemiluminescent technique (light and chemical )reaction,58.0,29.0,8.19,78.88,64
HCPCS,82435,Blood chloride level,48.0,24.0,2.21,65.28,32
HCPCS,82436,Urine chloride level,23.0,11.5,1.32,31.28,32
HCPCS,82438,Chloride level,28.0,14.0,1.4,38.08,32
HCPCS,82465,Cholesterol level,71.0,35.5,3.09,96.56,64
HCPCS,82495,Chromium level to test for poisoning or deficiency,106.0,53.0,12.53,144.16,32
HCPCS,82507,Citrate level,113.0,56.5,15.29,153.68,32
HCPCS,82523,"Collagen cross links test, (urine test to evaluate bone health)",68.0,34.0,12.17,92.48,32
HCPCS,82525,Copper level,63.0,31.5,7.82,85.68,32
HCPCS,82530,"Cortisol (hormone) measurement, free",68.0,34.0,11.36,92.48,32
HCPCS,82533,"Cortisol (hormone) measurement, total",146.0,73.0,13.43,198.56,32
HCPCS,82542,Chemical analysis using chromatography technique,119.0,59.5,12.17,190.4,192
HCPCS,82550,"Creatine kinase (cardiac enzyme) level, total",65.0,32.5,4.23,88.4,32
HCPCS,82552,"Creatine kinase (cardiac enzyme) level, isoenzymes",138.0,69.0,12.17,187.68,32
HCPCS,82553,"Creatine kinase (cardiac enzyme) level, MB fraction only",191.0,95.5,12.17,259.76,32
HCPCS,82565,Blood creatinine level,70.0,35.0,3.58,95.2,64
HCPCS,82570,Creatinine level to test for kidney function or muscle injury,89.0,44.5,4.61,121.04,32
HCPCS,82575,Creatinine clearance measurement to test for kidney function,158.0,79.0,5.5,214.88,32
HCPCS,82595,Cryoglobulin (protein) measurement,25.0,12.5,1.62,34.0,32
HCPCS,82607,Cyanocobalamin (vitamin B-12) level,162.0,81.0,13.43,220.32,32
HCPCS,82610,Cystatin C (enzyme inhibitor) level,68.0,34.0,12.17,92.48,32
HCPCS,82615,Cystine and homocystine (amino acids) analysis,272.0,136.0,5.5,369.92,32
HCPCS,82626,Dehydroepiandrosterone (DHEA) hormone level,92.0,46.0,12.17,125.12,32
HCPCS,82627,Dehydroepiandrosterone (DHEA-S) hormone level,129.0,64.5,13.43,175.44,32
HCPCS,82633,"Desoxycorticosterone, 11 (hormone) level",113.0,56.5,32.63,153.68,32
HCPCS,82634,"Deoxycortisol, 11 (hormone) level",146.0,73.0,13.43,198.56,32
HCPCS,82642,Measurement of dihydrotestosterone,106.0,53.0,13.43,144.16,32
HCPCS,82652,"Dihydroxyvitamin D, 1, 25 level",155.0,77.5,28.66,210.8,32
HCPCS,82653,Measurement of pancreatic elastase (enzyme) in stool,500.0,250.0,12.17,680.0,32
HCPCS,82657,"Enzyme activity measurement, nonradioactive substrate",382.0,191.0,12.17,519.52,96
HCPCS,82668,Erythropoietin (protein) level,233.0,116.5,12.17,316.88,32
HCPCS,82670,Measurement of total estradiol (hormone),187.0,93.5,13.43,254.32,32
HCPCS,82672,"Estrogen analysis, total",79.0,39.5,13.43,107.44,32
HCPCS,82677,Estriol (hormone) level,98.0,49.0,13.25,133.28,32
HCPCS,82679,Estrone (hormone) level,91.0,45.5,13.43,123.76,32
HCPCS,82693,Ethylene glycol (antifreeze) measurement,61.0,30.5,9.09,82.96,32
HCPCS,82705,"Stool fat or lipids analysis, qualitative",21.0,10.5,1.07,28.56,32
HCPCS,82710,"Stool fat or lipids analysis, quantitative",178.0,89.0,12.17,242.08,32
HCPCS,82726,Very long chain fatty acids level,539.0,269.5,12.17,733.04,32
HCPCS,82728,Ferritin (blood protein) level,146.0,73.0,12.17,198.56,32
HCPCS,82731,Fetal fibronectin (protein) analysis,375.0,187.5,63.21,510.0,32
HCPCS,82746,"Folic acid level, serum",157.0,78.5,12.17,213.52,32
HCPCS,82747,"Folic acid level, RBC",54.0,27.0,9.53,73.44,32
HCPCS,82775,Galactose-1-phosphate uridyl transferase (enzyme) level,74.0,37.0,12.17,100.64,32
HCPCS,82776,Galactose-1-phosphate uridyl transferase screening test,105.0,52.5,7.14,142.8,32
HCPCS,82784,Gammaglobulin (immune system protein) measurement,104.0,52.0,5.5,141.44,160
HCPCS,82785,IgE (immune system protein) level,96.0,48.0,12.17,130.56,32
HCPCS,82787,"Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses",137.0,68.5,5.5,186.32,32
HCPCS,82800,Blood pH level,92.0,46.0,8.16,125.12,32
HCPCS,82803,Blood gases measurement,230.0,115.0,28.66,312.8,32
HCPCS,82805,"Blood gases measurement, with O2 saturation",285.0,142.5,68.3,387.6,32
HCPCS,82810,"Blood gas, oxygen saturation measurement",58.0,29.0,5.5,78.88,32
HCPCS,82941,Gastrin (GI tract hormone) level,64.0,32.0,11.28,87.04,32
HCPCS,82943,Glucagon (pancreatic hormone) level,59.0,29.5,8.43,80.24,32
HCPCS,82945,Glucose (sugar) level on body fluid,67.0,33.5,2.63,91.12,32
HCPCS,82947,Blood glucose (sugar) level,60.0,30.0,2.36,81.6,32
HCPCS,82950,Blood glucose (sugar) level after receiving dose of glucose,91.0,45.5,4.32,123.76,32
HCPCS,82951,"Blood glucose (sugar) tolerance test, 3 specimens",128.0,64.0,12.17,174.08,32
HCPCS,82952,"Blood glucose (sugar) tolerance test, each additional beyond 3 specimens",39.0,19.5,1.53,53.04,32
HCPCS,82955,G6PD (enzyme) level,30.0,15.0,2.91,40.8,32
HCPCS,82962,Blood glucose (sugar) test performed by hand-held instrument,39.0,19.5,1.28,53.04,64
HCPCS,82977,Glutamyltransferase (liver enzyme) level,67.0,33.5,4.82,91.12,32
HCPCS,82985,Glycated protein level,61.0,30.5,10.22,82.96,32
HCPCS,83001,"Gonadotropin, follicle stimulating (reproductive hormone) level",189.0,94.5,13.43,257.04,64
HCPCS,83002,"Gonadotropin, luteinizing (reproductive hormone) level",189.0,94.5,13.43,257.04,32
HCPCS,83003,Human growth hormone level,61.0,30.5,10.17,82.96,32
HCPCS,83010,Haptoglobin (serum protein) level,129.0,64.5,12.17,175.44,32
HCPCS,83013,Breath test analysis for helicobacter pylori,244.0,122.0,69.31,331.84,32
HCPCS,83018,Heavy metal level,210.0,105.0,12.53,285.6,32
HCPCS,83020,"Hemoglobin analysis and measurement, electrophoresis",207.0,103.5,12.17,281.52,32
HCPCS,83033,Fetal hemoglobin analysis,28.0,14.0,2.24,38.08,32
HCPCS,83036,Hemoglobin A1C level,105.0,52.5,5.5,142.8,64
HCPCS,83050,"Methemoglobin (hemoglobin) analysis, quantitative",40.0,20.0,3.28,54.4,32
HCPCS,83051,Plasma hemoglobin level,93.0,46.5,5.5,126.48,32
HCPCS,83088,Histamine (immune system substance) level,120.0,60.0,28.66,163.2,32
HCPCS,83090,Homocysteine (amino acid) level,197.0,98.5,13.43,267.92,32
HCPCS,83150,Homovanillic acid (organic acid) level,82.0,41.0,13.43,111.52,32
HCPCS,83497,Hydroxyindolacetic acid (product of metabolism) level,47.0,23.5,6.06,63.92,32
HCPCS,83498,"Hydroxyprogesterone, 17-D (synthetic hormone) level",151.0,75.5,13.43,205.36,32
HCPCS,83516,"Analysis of substance using immunoassay technique, multiple step method",64.0,32.0,7.38,87.04,192
HCPCS,83519,"Measurement of substance using immunoassay technique, by radioimmunoassay",67.0,33.5,12.17,91.12,288
HCPCS,83520,Measurement of substance using immunoassay technique,257.5,128.75,12.17,489.6,352
HCPCS,83521,Measurement of immunoglobulin light chains,171.0,85.5,12.17,232.56,32
HCPCS,83525,"Insulin measurement, total",47.0,23.5,5.37,63.92,32
HCPCS,83529,Measurement of interleukin-6,238.0,119.0,12.17,323.68,32
HCPCS,83540,Iron level,97.0,48.5,5.5,131.92,32
HCPCS,83550,Iron binding capacity,114.0,57.0,5.5,155.04,32
HCPCS,83605,Lactic acid level,36.0,18.0,4.17,48.96,32
HCPCS,83615,Lactate dehydrogenase (enzyme) level,62.0,31.0,3.74,84.32,32
HCPCS,83625,Lactate dehydrogenase (enzyme) measurement,70.0,35.0,8.95,95.2,32
HCPCS,83631,Stool lactoferrin (immune system protein) level,448.0,224.0,12.17,609.28,32
HCPCS,83655,Lead level,70.0,35.0,8.48,95.2,32
HCPCS,83690,Lipase (fat enzyme) level,106.0,53.0,5.5,144.16,32
HCPCS,83695,Lipoprotein (A) level,53.0,26.5,7.59,72.08,32
HCPCS,83704,"Lipoprotein level, quantitation of lipoprotein particle number(s)",181.0,90.5,28.66,246.16,32
HCPCS,83718,HDL cholesterol level,113.0,56.5,5.5,153.68,32
HCPCS,83721,LDL cholesterol level,80.0,40.0,5.5,108.8,32
HCPCS,83735,Magnesium level,43.0,21.5,2.88,58.48,32
HCPCS,83785,Manganese (heavy metal) level,97.0,48.5,12.53,131.92,32
HCPCS,83789,Mass spectrometry (laboratory testing method),312.0,156.0,12.17,424.32,96
HCPCS,83825,Mercury level,66.0,33.0,10.73,89.76,32
HCPCS,83835,Metanephrines level,62.0,31.0,10.5,84.32,32
HCPCS,83873,"Myelin basic protein (nerve protein) level, spinal fluid",63.0,31.5,10.84,85.68,32
HCPCS,83874,Myoglobin (muscle protein) level,135.0,67.5,12.17,183.6,32
HCPCS,83876,Myeloperoxidase (white blood cell enzyme) measurement,184.0,92.0,15.29,250.24,32
HCPCS,83880,Natriuretic peptide (heart and blood vessel protein) level,206.0,103.0,28.66,280.16,32
HCPCS,83883,"Nephelometry, test method using light",113.0,56.5,11.72,153.68,32
HCPCS,83916,Measurement of immune substance (oligoclonal bands),110.0,55.0,23.44,149.6,32
HCPCS,83918,Organic acids level,285.0,142.5,12.53,387.6,32
HCPCS,83919,Organic acids analysis,381.0,190.5,12.17,518.16,32
HCPCS,83921,Organic acid level,86.0,43.0,12.17,116.96,32
HCPCS,83930,Blood osmolality (concentration) measurement,99.0,49.5,5.5,134.64,32
HCPCS,83935,Urine osmolality (concentration) measurement,90.0,45.0,5.5,122.4,32
HCPCS,83937,Osteocalcin (bone protein) level,108.0,54.0,32.24,146.88,32
HCPCS,83945,Oxalate level,136.0,68.0,12.17,184.96,32
HCPCS,83951,Oncoprotein (cancer related gene) measurement,233.0,116.5,28.66,316.88,32
HCPCS,83970,Parathormone (parathyroid hormone) level,338.0,169.0,35.6,459.68,32
HCPCS,83986,Body fluid pH level,79.0,39.5,2.83,107.44,64
HCPCS,83993,Stool calprotectin (protein) level,72.0,36.0,12.17,97.92,32
HCPCS,84030,"Phenylalanine, PKU (amino acid) level",75.0,37.5,4.13,102.0,32
HCPCS,84075,"Phosphatase (enzyme) level, alkaline",59.0,29.5,3.06,80.24,32
HCPCS,84080,"Phosphatase (enzyme) measurement, alkaline, isoenzymes",54.0,27.0,7.98,73.44,32
HCPCS,84100,Phosphate level,44.0,22.0,2.09,59.84,32
HCPCS,84105,Urine phosphate level,85.0,42.5,4.91,115.6,32
HCPCS,84110,Urine porphobilinogen (metabolism substance) level,88.0,44.0,5.5,119.68,32
HCPCS,84112,Cervicovaginal secretion of placenta protein,311.0,155.5,69.31,422.96,32
HCPCS,84120,Urine porphyrins (metabolism substance) measurement,140.0,70.0,12.17,190.4,32
HCPCS,84132,Blood potassium level,60.0,30.0,2.86,81.6,32
HCPCS,84133,Urine potassium level,54.0,27.0,2.55,73.44,32
HCPCS,84134,Prealbumin (protein) level,113.0,56.5,12.17,153.68,32
HCPCS,84140,Pregnenolone (reproductive hormone) level,224.0,112.0,13.43,304.64,32
HCPCS,84143,17-hydroxypregnenolone (hormone) level,280.0,140.0,13.43,380.8,32
HCPCS,84144,Progesterone (reproductive hormone) level,193.0,96.5,13.43,262.48,32
HCPCS,84145,Procalcitonin (hormone) level,118.0,59.0,13.43,160.48,32
HCPCS,84146,Prolactin (milk producing hormone) level,211.0,105.5,13.43,286.96,32
HCPCS,84153,"PSA (prostate specific antigen) measurement, total",191.0,95.5,12.17,259.76,32
HCPCS,84154,"PSA (prostate specific antigen) measurement, free",196.0,98.0,12.17,266.56,32
HCPCS,84155,"Total protein level, blood",49.0,24.5,1.8,66.64,32
HCPCS,84156,"Total protein level, urine",57.0,28.5,2.09,77.52,32
HCPCS,84157,"Total protein level, body fluid",50.0,25.0,2.0,68.0,32
HCPCS,84165,"Protein measurement, serum",224.0,112.0,5.5,304.64,32
HCPCS,84166,"Protein measurement, body fluid",187.0,93.5,12.17,254.32,32
HCPCS,84181,Protein measurement,262.0,131.0,11.72,356.32,32
HCPCS,84182,"Protein measurement, immunological probe for band identification",381.0,190.5,34.67,518.16,32
HCPCS,84202,Protoporphyrin (metabolism substance) level,51.0,25.5,7.32,69.36,32
HCPCS,84206,Proinsulin (pancreatic hormone) level,97.0,48.5,13.43,131.92,32
HCPCS,84207,Vitamin B-6 level,102.0,51.0,28.66,138.72,32
HCPCS,84210,Pyruvate (organic acid) level,53.0,26.5,7.67,72.08,32
HCPCS,84238,Chemical receptor analysis,133.0,66.5,28.66,180.88,32
HCPCS,84244,Renin (kidney enzyme) level,80.0,40.0,13.43,108.8,32
HCPCS,84255,Selenium (vitamin) level,104.0,52.0,12.53,141.44,32
HCPCS,84260,Serotonin (hormone) level,262.0,131.0,35.6,356.32,32
HCPCS,84270,Sex hormone binding globulin (protein) level,89.0,44.5,12.17,121.04,32
HCPCS,84275,Sialic acid (organic acid) level,46.0,23.0,6.18,62.56,32
HCPCS,84295,Blood sodium level,56.0,28.0,2.69,76.16,32
HCPCS,84300,Urine sodium level,22.0,11.0,1.11,29.92,32
HCPCS,84302,Sodium level,21.0,10.5,1.02,28.56,64
HCPCS,84305,Somatomedin (growth factor) level,135.0,67.5,13.43,183.6,32
HCPCS,84311,Chemical analysis using spectrophotometry (light),126.0,63.0,5.5,171.36,96
HCPCS,84315,Specific gravity (liquid weight) measurement,32.0,16.0,1.05,43.52,32
HCPCS,84376,"Carbohydrate analysis, single qualitative",23.0,11.5,1.27,31.28,32
HCPCS,84377,"Carbohydrate analysis, multiple qualitative",23.0,11.5,1.27,31.28,32
HCPCS,84392,Urine sulfate (acid) level,158.0,79.0,3.06,214.88,32
HCPCS,84402,"Testosterone (hormone) level, free",146.0,73.0,13.43,198.56,32
HCPCS,84403,"Testosterone (hormone) level, total",199.0,99.5,13.43,270.64,32
HCPCS,84410,Testosterone level,177.0,88.5,35.6,240.72,32
HCPCS,84425,Vitamin B-1 (thiamine) level,86.0,43.0,12.17,116.96,32
HCPCS,84432,Thyroglobulin (thyroid related hormone) level,159.0,79.5,13.43,216.24,32
HCPCS,84433,Evaluation of thiopurine S-methyltransferase (TPMT),300.0,150.0,12.17,408.0,32
HCPCS,84436,"Thyroxine (thyroid chemical), total",105.0,52.5,7.21,142.8,32
HCPCS,84437,"Thyroxine (thyroid chemical), requiring elution",265.0,132.5,8.16,360.4,32
HCPCS,84439,"Thyroxine (thyroid chemical), free",114.0,57.0,10.28,155.04,32
HCPCS,84442,Thyroxine binding globulin (thyroid related protein) level,54.0,27.0,7.98,73.44,32
HCPCS,84443,"Blood test, thyroid stimulating hormone (TSH)",159.0,79.5,13.43,216.24,32
HCPCS,84445,Thyroid stimulating immune globulins (thyroid related protein) level,184.0,92.0,35.6,250.24,32
HCPCS,84446,Vitamin E level,52.0,26.0,7.37,70.72,32
HCPCS,84449,Transcortin (cortisol binding protein) level,131.0,65.5,13.43,178.16,32
HCPCS,84450,"Liver enzyme (SGOT), level",53.0,26.5,2.75,72.08,32
HCPCS,84460,"Liver enzyme (SGPT), level",56.0,28.0,2.97,76.16,32
HCPCS,84466,Transferrin (iron binding protein) level,95.0,47.5,12.12,129.2,32
HCPCS,84478,Triglycerides level,61.0,30.5,3.5,82.96,32
HCPCS,84479,Thyroid hormone evaluation,60.0,30.0,3.88,81.6,32
HCPCS,84480,"Thyroid hormone, T3 measurement, total",123.0,61.5,13.43,167.28,32
HCPCS,84481,"Thyroid hormone, T3 measurement, free",152.0,76.0,13.25,206.72,32
HCPCS,84482,"Thyroid hormone, T3 measurement, reverse",58.0,29.0,9.14,78.88,32
HCPCS,84484,"Troponin (protein) analysis, quantitative",130.0,65.0,12.17,176.8,32
HCPCS,84520,"Urea nitrogen level to assess kidney function, quantitative",40.0,20.0,1.58,54.4,32
HCPCS,84540,"Urea nitrogen level to assess kidney function, urine",60.0,30.0,3.34,81.6,32
HCPCS,84550,"Uric acid level, blood",79.0,39.5,3.57,107.44,32
HCPCS,84560,Uric acid level,74.0,37.0,3.76,100.64,32
HCPCS,84585,Urine vanillylmandelic acid,57.0,28.5,8.84,77.52,32
HCPCS,84586,Vasoactive intestinal peptide (intestinal hormone) level,143.0,71.5,35.6,194.48,32
HCPCS,84588,ADH (antidiuretic hormone) level,219.0,109.5,33.64,297.84,32
HCPCS,84590,Vitamin A level,43.0,21.5,4.99,58.48,32
HCPCS,84591,Vitamin measurement,69.0,34.5,11.77,93.84,64
HCPCS,84597,Vitamin K level,143.0,71.5,12.17,194.48,32
HCPCS,84600,Volatile chemical measurement,278.0,139.0,12.17,378.08,32
HCPCS,84630,Zinc level,42.0,21.0,4.78,57.12,32
HCPCS,84681,C-peptide (protein) level,76.0,38.0,12.17,103.36,32
HCPCS,84702,"Gonadotropin, chorionic (reproductive hormone) level",186.0,93.0,13.43,252.96,32
HCPCS,84703,Gonadotropin (reproductive hormone) analysis,86.0,43.0,5.5,116.96,32
HCPCS,84999,Chemistry procedures,416.56,208.28,0.5,900.49,96
HCPCS,85007,Microscopic examination for white blood cells with manual cell count,60.0,30.0,2.28,81.6,32
HCPCS,85009,Manual white blood cell count and evaluation,81.0,40.5,4.11,110.16,32
HCPCS,85013,Red blood cell hemoglobin concentration,56.0,28.0,3.92,76.16,32
HCPCS,85014,Red blood cell concentration measurement,43.0,21.5,1.02,58.48,32
HCPCS,85018,"Blood count, hemoglobin",38.0,19.0,0.9,51.68,32
HCPCS,85025,"Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count",93.0,46.5,6.04,126.48,32
HCPCS,85027,"Complete blood cell count (red cells, white blood cell, platelets), automated test",105.0,52.5,6.04,142.8,32
HCPCS,85044,"Red blood count, manual test",72.0,36.0,3.1,97.92,32
HCPCS,85045,"Red blood count, automated test",68.0,34.0,2.71,92.48,32
HCPCS,85048,Automated white blood cell count,48.0,24.0,1.22,65.28,32
HCPCS,85049,"Platelet count, automated test",61.0,30.5,2.73,82.96,32
HCPCS,85055,Reticulated (young) platelet measurement,44.0,22.0,15.73,128.66,32
HCPCS,85060,Blood smear interpretation by physician with written report,88.0,44.0,17.35,45.71,32
HCPCS,85097,"Bone marrow, smear interpretation",1277.0,638.5,57.84,2795.44,32
HCPCS,85130,Assessment of blood clotting function,193.0,96.5,6.04,262.48,32
HCPCS,85210,"Clotting factor II prothrombin, measurement",187.0,93.5,4.51,254.32,32
HCPCS,85220,Clotting factor V (AcG or proaccelerin) measurement,226.0,113.0,4.51,307.36,32
HCPCS,85230,"Clotting factor VII (proconvertin, stable factor)",219.0,109.5,4.51,297.84,32
HCPCS,85240,Clotting factor VIII (AHG) measurement,208.0,104.0,4.51,282.88,32
HCPCS,85245,Clotting factor VIII (VW factor) measurement,393.0,196.5,17.32,534.48,32
HCPCS,85246,Clotting factor VIII (VW factor) antigen,266.0,133.0,17.32,361.76,32
HCPCS,85247,Clotting factor VIII (von Willebrand factor) measurement,625.0,312.5,25.78,850.0,32
HCPCS,85250,Clotting factor IX (PTC or Christmas) measurement,289.0,144.5,22.42,393.04,32
HCPCS,85260,Clotting factor X (Stuart-Prower) measurement,175.0,87.5,4.51,238.0,32
HCPCS,85270,Clotting factor XI (PTA) measurement,182.0,91.0,4.51,247.52,32
HCPCS,85280,Clotting factor XII (Hageman) measurement,78.0,39.0,15.09,106.08,32
HCPCS,85291,Clotting factor XIII (fibrin stabilizing) screening test,34.0,17.0,3.1,46.24,32
HCPCS,85300,Antithrombin III antigen (clotting inhibitor) activity,171.0,85.5,4.51,232.56,32
HCPCS,85301,Antithrombin III antigen (clotting inhibitor) level,40.0,20.0,4.32,54.4,32
HCPCS,85302,"Protein C, (clotting inhibitor) activity",44.0,22.0,4.51,59.84,32
HCPCS,85303,Protein C antigen (clotting inhibitor) measurement,200.0,100.0,4.51,272.0,32
HCPCS,85305,Protein S (clotting inhibitor) level,136.0,68.0,4.51,184.96,32
HCPCS,85306,Protein S (clotting inhibitor) measurement,285.0,142.5,4.51,387.6,32
HCPCS,85307,Activated protein resistance assay,116.0,58.0,6.04,157.76,32
HCPCS,85335,Clotting factor inhibitor test,260.0,130.0,4.51,353.6,32
HCPCS,85347,"Coagulation time measurement, activated",40.0,20.0,1.71,54.4,32
HCPCS,85379,"Coagulation function measurement, D-dimer; quantitative",120.0,60.0,4.51,163.2,32
HCPCS,85384,Fibrinogen (factor 1) activity measurement,60.0,30.0,4.51,81.6,32
HCPCS,85397,Measurement of blood coagulation and fibrinolysis (clot dissolving) function,216.0,108.0,25.78,293.76,32
HCPCS,85410,Alpha-2 antiplasmin (factor inhibitor) measurement,28.0,14.0,2.16,38.08,32
HCPCS,85415,Plasminogen activator (fibrinolytic factor) measurement,70.0,35.0,4.51,95.2,32
HCPCS,85420,Plasminogen (fibrinolytic factor) measurement,282.0,141.0,4.51,383.52,32
HCPCS,85460,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis",578.0,289.0,6.04,786.08,32
HCPCS,85461,"Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette",64.0,32.0,5.99,87.04,32
HCPCS,85520,Heparin assay,48.0,24.0,4.51,65.28,32
HCPCS,85549,White blood cell enzyme activity measurement,137.0,68.5,6.04,186.32,32
HCPCS,85576,Platelet aggregation function test,236.0,118.0,25.49,320.96,64
HCPCS,85597,Platelet function test,160.0,80.0,4.51,217.6,32
HCPCS,85598,Phospholipid test,212.0,106.0,4.51,288.32,32
HCPCS,85610,"Blood test, clotting time",50.0,25.0,2.15,68.0,64
HCPCS,85613,"Clotting factor X assessment test, diluted",32.0,16.0,3.07,43.52,32
HCPCS,85635,Blood coagulation screening test,35.0,17.5,3.45,47.6,32
HCPCS,85652,"Red blood cell sedimentation rate, to detect inflammation, automated",74.0,37.0,2.0,100.64,32
HCPCS,85660,Red blood cell sickling measurement,83.0,41.5,4.57,112.88,64
HCPCS,85670,"Thrombin time, fibrinogen screening test, plasma",50.0,25.0,2.89,68.0,32
HCPCS,85705,Thromboplastin inhibition (circulating anticoagulant) measurement,130.0,65.0,4.51,176.8,32
HCPCS,85730,"Coagulation assessment blood test, plasma or whole blood",130.0,65.0,4.51,176.8,32
HCPCS,85732,"Coagulation assessment blood test, substitution, plasma fractions",105.0,52.5,4.51,142.8,32
HCPCS,85810,Blood viscosity measurement,43.0,21.5,5.02,58.48,32
HCPCS,86001,"Measurement of antibody (IgG) to allergic substance, each allergen",52.0,26.0,4.07,70.72,32
HCPCS,86003,"Measurement of antibody (IgE) to allergic substance, crude allergen extract, each",41.0,20.5,2.14,55.76,32
HCPCS,86008,"Measurement of antibody (IgE) to allergic substance, recombinant or purified component, each",239.0,119.5,11.72,325.04,32
HCPCS,86015,Measurement of Actin (smooth muscle) antibody,93.0,46.5,11.21,126.48,32
HCPCS,86021,Antibody identification test for white blood cell antibodies,228.0,114.0,11.72,310.08,32
HCPCS,86022,"Antibody identification test, platelet antibodies",76.0,38.0,11.72,103.36,64
HCPCS,86036,Screening test for antineutrophil cytoplasmic antibody,206.0,103.0,11.72,280.16,32
HCPCS,86037,Antineutrophil cytoplasmic antibody titer,86.0,43.0,10.36,116.96,32
HCPCS,86038,Screening test for autoimmune disorder,102.0,51.0,11.72,138.72,32
HCPCS,86039,"Measurement of antibody for assessment of autoimmune disorder, titer",106.0,53.0,11.72,144.16,32
HCPCS,86041,Test for acetylcholine receptor binding antibody,343.0,171.5,59.8,466.48,28
HCPCS,86042,Test for acetylcholine receptor blocking antibody,298.0,149.0,54.83,405.28,28
HCPCS,86043,Test for acetylcholine receptor modulating antibody,310.0,155.0,37.36,421.6,28
HCPCS,86051,ELISA detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,238.0,119.0,11.72,323.68,32
HCPCS,86053,Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody,130.0,65.0,39.0,176.8,32
HCPCS,86060,Measurement for Strep antibody (strep throat),27.0,13.5,1.97,36.72,32
HCPCS,86140,Measurement C-reactive protein for detection of infection or inflammation,85.0,42.5,4.4,115.6,32
HCPCS,86141,"Measurement C-reactive protein for detection of infection or inflammation, high sensitivity",106.0,53.0,11.72,144.16,32
HCPCS,86146,Beta 2 glycoprotein 1 antibody (autoantibody) measurement,78.0,39.0,11.72,106.08,32
HCPCS,86147,Cardiolipin antibody (tissue antibody) measurement,103.0,51.5,11.72,144.61,32
HCPCS,86148,Phospholipid antibody (autoimmune antibody) measurement,675.0,337.5,11.72,918.0,32
HCPCS,86156,Measurement of cold agglutinin (protein) to screen for infection or disease,214.0,107.0,8.16,291.04,32
HCPCS,86160,"Measurement of complement (immune system proteins), antigen,",140.0,70.0,11.72,190.4,224
HCPCS,86161,Measurement of complement function (immune system proteins),48.0,24.0,5.76,65.28,32
HCPCS,86162,"Measurement of complement (immune system proteins), total hemolytic",129.0,64.5,11.72,175.44,32
HCPCS,86200,Measurement of antibody for rheumatoid arthritis assessment,48.0,24.0,6.22,65.28,32
HCPCS,86215,Measurement of DNA antibody,54.0,27.0,7.16,73.44,32
HCPCS,86225,"Measurement of DNA antibody, native or double stranded",137.0,68.5,11.72,186.32,32
HCPCS,86231,Detection of endomysial antibody (EMA),347.0,173.5,11.72,471.92,32
HCPCS,86235,"Measurement of antibody for assessment of autoimmune disorder, any method",110.0,55.0,11.72,149.6,384
HCPCS,86255,Screening test for antibody to noninfectious agent,176.0,88.0,11.72,239.36,256
HCPCS,86256,Measurement of antibody to noninfectious agent,69.0,34.5,8.31,93.84,32
HCPCS,86258,Detection of gliadin (deamidated) (DGP) antibody,148.0,74.0,11.72,201.28,32
HCPCS,86300,"Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3",184.0,92.0,11.72,250.24,32
HCPCS,86301,"Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9",76.0,38.0,11.72,103.36,32
HCPCS,86304,"Immunologic analysis for detection of tumor antigen, quantitative; CA 125",250.0,125.0,11.72,340.0,32
HCPCS,86305,Analysis of female reproductive genetic marker,442.0,221.0,11.72,601.12,32
HCPCS,86308,Screening test for mononucleosis (mono),130.0,65.0,6.73,176.8,32
HCPCS,86316,Analysis for detection of tumor marker,140.0,70.0,11.72,190.4,96
HCPCS,86317,"Detection of infectious agent antibody, quantitative",98.0,49.0,11.72,133.28,96
HCPCS,86331,Immunologic analysis for detection of antigen or antibody,952.0,476.0,11.72,1294.72,32
HCPCS,86332,Immune complex measurement,165.0,82.5,11.72,224.4,32
HCPCS,86334,Immunologic analysis technique on serum (immunofixation),314.0,157.0,11.72,427.04,32
HCPCS,86335,"Immunologic analysis technique on body fluid, other fluids with concentration",340.0,170.0,34.67,462.4,32
HCPCS,86336,Inhibin A (reproductive organ hormone) measurement,57.0,28.5,8.89,77.52,32
HCPCS,86337,Insulin antibody measurement,86.0,43.0,11.72,116.96,32
HCPCS,86340,Intrinsic factor (stomach protein) antibody measurement,55.0,27.5,8.29,74.8,32
HCPCS,86341,Islet cell (pancreas) antibody measurement,86.0,43.0,11.72,116.96,32
HCPCS,86352,Analysis of cell function and analysis for genetic marker,684.0,342.0,41.55,930.24,32
HCPCS,86355,Total cell count for B cells (white blood cells),176.0,88.0,41.55,239.36,32
HCPCS,86357,Total cell count for natural killer cells (white blood cell),202.0,101.0,41.55,274.72,32
HCPCS,86359,"T cells count, total",210.0,105.0,41.55,285.6,32
HCPCS,86360,"T cell count and ratio, including ratio",336.0,168.0,41.55,456.96,32
HCPCS,86361,T cell count and ratio,275.0,137.5,16.31,374.0,32
HCPCS,86363,Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody,130.0,65.0,39.0,176.8,64
HCPCS,86364,Measurement of tissue transglutaminase,255.0,127.5,11.72,346.8,32
HCPCS,86366,Test for muscle-specific kinase antibody,343.0,171.5,59.8,466.48,28
HCPCS,86367,"Stem cells count, total",355.0,177.5,41.55,482.8,32
HCPCS,86376,Microsomal antibodies (autoantibody) measurement,135.0,67.5,11.72,183.6,96
HCPCS,86381,Measurement of mitochondrial antibody,155.0,77.5,11.72,210.8,32
HCPCS,86431,Rheumatoid factor level,70.0,35.0,3.97,95.2,32
HCPCS,86480,"Tuberculosis test, gamma interferon",224.0,112.0,41.55,304.64,32
HCPCS,86580,Skin test for tuberculosis,76.0,38.0,10.2,103.36,32
HCPCS,86592,Syphilis detection test,65.0,32.5,2.78,88.4,32
HCPCS,86593,Syphilis test,73.0,36.5,3.21,99.28,32
HCPCS,86596,Measurement of voltage-gated calcium channel antibody,315.0,157.5,11.72,428.4,32
HCPCS,86602,Analysis for antibody to actinomyces (bacteria),70.0,35.0,7.13,95.2,32
HCPCS,86606,Analysis for antibody to aspergillus (fungus),71.0,35.5,10.69,96.56,32
HCPCS,86609,Analysis for antibody bacteria,151.0,75.5,11.72,205.36,32
HCPCS,86611,Analysis for antibody to Bartonella (bacteria),53.0,26.5,5.4,72.08,32
HCPCS,86612,Analysis for antibody to blastomyces (fungus),78.0,39.0,10.06,106.08,32
HCPCS,86617,Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria),188.0,94.0,11.72,255.68,32
HCPCS,86618,Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria),93.0,46.5,11.72,126.48,32
HCPCS,86622,Analysis for antibody to Brucella (bacteria),70.0,35.0,6.25,95.2,32
HCPCS,86631,Analysis for antibody to Chlamydia (bacteria),83.0,41.5,9.81,112.88,32
HCPCS,86632,Analysis for antibody (IgM) to Chlamydia (bacteria),464.0,232.0,11.72,631.04,32
HCPCS,86635,Analysis for antibody to Coccidioides (bacteria),255.0,127.5,11.72,346.8,32
HCPCS,86638,Analysis for antibody to Coxiella burnetii (Q fever bacteria),101.0,50.5,11.72,137.36,32
HCPCS,86641,Analysis for antibody to Cryptococcus (yeast),142.0,71.0,11.72,193.12,32
HCPCS,86644,Analysis for antibody to Cytomegalovirus (CMV),162.0,81.0,11.72,220.32,32
HCPCS,86645,Analysis for antibody (IgM) to Cytomegalovirus (CMV),92.0,46.0,11.72,125.12,32
HCPCS,86651,Analysis for antibody to La crosse (California) virus (encephalitis causing virus),341.0,170.5,11.72,463.76,32
HCPCS,86652,Analysis for antibody to Eastern equine virus (viral encephalitis),46.0,23.0,6.07,62.56,32
HCPCS,86653,Analysis for antibody to St. Louis virus (viral encephalitis),46.0,23.0,6.07,62.56,32
HCPCS,86654,Analysis for antibody to Western equine virus (viral encephalitis),46.0,23.0,6.07,62.56,32
HCPCS,86658,Analysis for antibody to Enterovirus (gastrointestinal virus),96.0,48.0,11.72,130.56,32
HCPCS,86663,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen",94.0,47.0,11.72,127.84,32
HCPCS,86664,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen",138.0,69.0,11.72,187.68,32
HCPCS,86665,"Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid",107.0,53.5,11.72,145.52,32
HCPCS,86666,Analysis for antibody to Ehrlichia (bacteria transmitted by ticks),36.0,18.0,3.66,48.96,32
HCPCS,86671,Analysis for antibody to fungus,65.0,32.5,7.96,88.4,96
HCPCS,86682,Analysis for antibody to helminth (intestinal worm),53.0,26.5,6.9,72.08,64
HCPCS,86687,"Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)",79.0,39.5,7.18,107.44,32
HCPCS,86688,"Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)",89.0,44.5,11.72,121.04,32
HCPCS,86692,Analysis for antibody to Hepatitis D virus,70.0,35.0,11.72,95.2,32
HCPCS,86695,"Analysis for antibody to Herpes simplex virus, type 1",96.0,48.0,11.72,130.56,32
HCPCS,86696,"Analysis for antibody to Herpes simplex virus, type 2",110.0,55.0,11.72,149.6,32
HCPCS,86698,Analysis for antibody to histoplasma (fungus),51.0,25.5,7.03,69.36,32
HCPCS,86701,Analysis for antibody to HIV -1 virus,118.0,59.0,10.49,160.48,32
HCPCS,86702,Analysis for antibody to HIV-2 virus,103.0,51.5,11.72,140.08,32
HCPCS,86703,Analysis for antibody to HIV-1 and HIV-2 virus,135.0,67.5,11.72,183.6,32
HCPCS,86704,Hepatitis B core antibody measurement,134.0,67.0,11.72,182.24,32
HCPCS,86705,Hepatitis B core antibody (IgM) measurement,132.0,66.0,11.72,179.52,32
HCPCS,86706,Hepatitis B surface antibody measurement,149.0,74.5,11.72,202.64,32
HCPCS,86707,Hepatitis Be antibody measurement,43.0,21.5,4.98,58.48,32
HCPCS,86708,Measurement of Hepatitis A antibody,227.0,113.5,11.72,308.72,32
HCPCS,86709,Measurement of Hepatitis A antibody (IgM),126.0,63.0,11.72,171.36,32
HCPCS,86711,Analysis for antibody to john cunningham virus,3401.0,1700.5,11.72,4625.36,32
HCPCS,86720,Analysis for antibody to Leptospira,124.0,62.0,11.72,168.64,32
HCPCS,86735,Analysis for antibody to mumps virus,90.0,45.0,11.72,122.4,32
HCPCS,86738,Analysis for antibody to Mycoplasma (bacteria),123.0,61.5,11.72,167.28,32
HCPCS,86747,Analysis for antibody to parvovirus,106.0,53.0,11.72,144.16,32
HCPCS,86753,Analysis for antibody to protozoa (parasite),92.0,46.0,11.4,125.12,96
HCPCS,86757,Analysis for antibody to Rickettsia (bacteria),68.0,34.0,11.72,92.48,32
HCPCS,86762,Analysis for antibody to Rubella (German measles virus),128.0,64.0,11.72,174.08,32
HCPCS,86765,Analysis for antibody to Rubeola (measles virus),100.0,50.0,11.72,136.0,32
HCPCS,86769,Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody,153.0,76.5,11.72,208.08,32
HCPCS,86777,Analysis for antibody to Toxoplasma (parasite),56.0,28.0,8.06,76.16,32
HCPCS,86778,Analysis for antibody (IgM) to Toxoplasma (parasite),57.0,28.5,8.21,77.52,32
HCPCS,86780,"Analysis for antibody, Treponema pallidum",120.0,60.0,11.72,163.2,32
HCPCS,86787,Analysis for antibody to varicella-zoster virus (chicken pox),123.0,61.5,11.72,167.28,32
HCPCS,86788,Analysis for antibody (IgM) to West Nile virus,59.0,29.5,9.94,80.24,32
HCPCS,86789,Analysis for antibody to West Nile virus,75.0,37.5,10.79,102.0,32
HCPCS,86790,Analysis for antibody to virus,116.0,58.0,11.72,157.76,160
HCPCS,86800,Thyroglobulin (thyroid protein) antibody measurement,130.0,65.0,11.72,176.8,32
HCPCS,86803,Hepatitis C antibody measurement,186.0,93.0,11.72,252.96,32
HCPCS,86812,"Immunologic analysis for autoimmune disease, A, B, or C, single antigen",177.0,88.5,4.51,240.72,32
HCPCS,86828,Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) antigens,1072.0,536.0,63.54,1457.92,32
HCPCS,86830,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class I",505.0,252.5,63.54,686.8,32
HCPCS,86831,"Assessment of antibody to human leukocyte antigens (HLA) with antibody identification by qualitative panel using complete HLA phenotypes, HLA class II",505.0,252.5,63.54,686.8,32
HCPCS,86832,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class I",1166.0,583.0,164.94,3774.93,32
HCPCS,86833,"Assessment of antibody to human leukocyte antigens (HLA) with high definition qualitative panel for identification of antibody specificities, HLA class II",1173.0,586.5,164.94,3821.63,32
HCPCS,86849,Immunology procedures,377.0,188.5,0.5,512.72,32
HCPCS,86850,Screening test for red blood cell antibodies,191.0,95.5,4.51,331.84,64
HCPCS,86860,Removal of antibodies from surface of red blood cell,256.5,128.25,24.47,566.1,64
HCPCS,86870,Identification of red blood cell antibodies,761.5,380.75,37.72,1587.12,320
HCPCS,86880,"Red blood cell antibody detection test, direct",95.0,47.5,4.51,129.2,128
HCPCS,86886,Red blood cell antibody level,169.0,84.5,4.51,229.84,64
HCPCS,86900,Blood group typing (ABO),191.0,95.5,4.51,274.72,64
HCPCS,86901,Blood typing for Rh (D) antigen,67.5,33.75,1.82,100.64,64
HCPCS,86902,"Screening test for compatible blood unit, using reagent serum",562.0,281.0,4.51,764.32,96
HCPCS,86905,Blood typing for red blood cell antigens,361.0,180.5,4.08,764.32,64
HCPCS,86906,Blood typing Rh phenotyping,256.0,128.0,4.51,348.16,64
HCPCS,86920,"Blood unit compatibility test, immediate spin technique",567.0,283.5,19.37,771.12,32
HCPCS,86922,"Blood unit compatibility test, antiglobulin technique",467.5,233.75,25.22,771.12,64
HCPCS,86923,"Blood unit compatibility test, electronic",567.0,283.5,24.47,771.12,32
HCPCS,86940,Red blood cell antibody screening test,191.0,95.5,4.51,259.76,32
HCPCS,86945,"Irradiation of blood product, each unit",115.0,57.5,29.56,156.4,32
HCPCS,86970,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with chemical agents or drugs",149.5,74.75,20.39,280.16,64
HCPCS,86971,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, incubation with enzymes",395.0,197.5,40.93,1166.8,64
HCPCS,86972,"Pretreatment of red blood cells for use in red blood cells antibody analysis and measurement, by density gradient separation",379.0,189.5,32.63,666.4,64
HCPCS,86978,"Pretreatment of serum for use in red blood cell antibody analysis and measurement, by differential red cell absorption",276.5,138.25,27.53,579.36,64
HCPCS,86985,Splitting of blood or blood products,268.0,134.0,20.39,566.1,32
HCPCS,87015,Concentration of specimen for infectious agents,64.0,32.0,4.28,87.04,32
HCPCS,87040,Bacterial blood culture,254.0,127.0,10.73,345.44,32
HCPCS,87045,Stool culture,128.0,64.0,10.73,174.08,32
HCPCS,87046,"Stool culture, additional pathogens",71.0,35.5,6.7,96.56,32
HCPCS,87070,"Bacterial culture, any other source except urine, blood or stool, aerobic",70.0,35.0,6.03,95.2,192
HCPCS,87071,Bacterial culture and colony count,194.0,97.0,10.73,263.84,64
HCPCS,87075,"Bacterial culture, any source, except blood, anaerobic",211.0,105.5,10.73,286.96,32
HCPCS,87076,Bacterial culture for anaerobic isolates,86.0,43.0,5.1,116.96,32
HCPCS,87077,Bacterial culture for aerobic isolates,49.0,24.5,3.96,66.64,32
HCPCS,87081,Screening test for pathogenic organisms,61.0,30.5,4.04,82.96,224
HCPCS,87086,"Bacterial colony count, urine",123.0,61.5,9.93,167.28,32
HCPCS,87088,Bacterial urine culture,91.0,45.5,7.36,123.76,32
HCPCS,87101,"Fungal culture (mold or yeast) of skin, hair, or nail",135.0,67.5,9.18,183.6,32
HCPCS,87102,Fungal culture (mold or yeast),115.0,57.5,9.67,156.4,32
HCPCS,87103,Fungal blood culture (mold or yeast),145.0,72.5,10.73,197.2,32
HCPCS,87106,"Fungal culture, yeast",112.0,56.0,10.73,152.32,32
HCPCS,87107,Culture for identification of yeast,120.0,60.0,10.73,163.2,32
HCPCS,87109,Mycoplasma culture,56.0,28.0,8.62,76.16,32
HCPCS,87116,Culture for acid-fast bacilli,150.0,75.0,10.73,204.0,32
HCPCS,87118,Identification of mycobacteria (TB or TB like organism),123.0,61.5,10.73,167.28,32
HCPCS,87147,"Identification of organisms by immunologic analysis, other than immunofluorescence method",47.0,23.5,2.43,63.92,32
HCPCS,87150,"Identification of organisms by genetic analysis, amplified probe technique",117.0,58.5,37.44,159.12,64
HCPCS,87168,Macroscopic examination (visual inspection) of insect,65.0,32.5,2.78,88.4,32
HCPCS,87169,Macroscopic examination (visual inspection) of parasite,37.0,18.5,1.59,50.32,32
HCPCS,87172,Pinworm test,78.0,39.0,3.33,106.08,32
HCPCS,87176,Tissue preparation for culture,57.0,28.5,3.35,77.52,32
HCPCS,87177,Smear for parasites,54.0,27.0,4.81,73.44,32
HCPCS,87181,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method",132.0,66.0,6.12,179.52,32
HCPCS,87184,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)",78.0,39.0,5.83,106.08,32
HCPCS,87186,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution",118.0,59.0,10.21,160.48,32
HCPCS,87188,"Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), macrobroth dilution method",138.0,69.0,8.16,187.68,32
HCPCS,87205,Special Gram or Giemsa stain for microorganism,72.0,36.0,3.07,97.92,32
HCPCS,87206,Special fluorescent and/or acid fast stain for microorganism,40.0,20.0,2.16,54.4,32
HCPCS,87207,Special stain for inclusion bodies or parasites,133.0,66.5,7.97,180.88,32
HCPCS,87209,Special stain for parasites,79.0,39.5,10.73,107.44,32
HCPCS,87210,Smear for infectious agents,60.0,30.0,3.49,81.6,32
HCPCS,87220,Tissue fungi or parasites,86.0,43.0,3.67,116.96,32
HCPCS,87254,"Virus isolation, centrifuge enhanced",193.0,96.5,10.73,262.48,32
HCPCS,87255,Virus isolation,130.0,65.0,40.78,176.8,32
HCPCS,87301,Detection test by immunoassay technique for adenovirus enteric types 40/41,44.0,22.0,5.27,59.84,32
HCPCS,87305,Detection test by immunoassay technique for Aspergillus (fungus),133.0,66.5,10.73,180.88,32
HCPCS,87324,Detection test by immunoassay technique for Clostridium difficile toxins (stool pathogen),118.0,59.0,10.73,160.48,32
HCPCS,87327,"Detection test by immunoassay technique, multistep method, for Cryptococcus neoformans (yeast)",109.0,54.5,10.73,148.24,32
HCPCS,87328,Detection test by immunoassay technique for Cryptosporidium (parasite),104.0,52.0,10.73,141.44,32
HCPCS,87329,Detection test by immunoassay technique for Giardia (intestinal parasite),147.0,73.5,10.73,199.92,32
HCPCS,87337,Detection test by immunoassay technique for Entamoeba histolytica group (parasite),121.0,60.5,10.73,164.56,32
HCPCS,87338,Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool,145.0,72.5,10.73,197.2,32
HCPCS,87340,Detection test by immunoassay technique for hepatitis B surface antigen,135.0,67.5,10.73,183.6,32
HCPCS,87350,Detection test by immunoassay technique for hepatitis Be surface antigen,47.0,23.5,5.42,63.92,32
HCPCS,87385,Detection test by immunoassay technique for Histoplasma capsulatum (parasite),230.0,115.0,10.73,312.8,32
HCPCS,87389,Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies,179.0,89.5,10.73,243.44,32
HCPCS,87425,Detection test by immunoassay technique for rotavirus,44.0,22.0,5.27,59.84,32
HCPCS,87430,"Detection test by immunoassay technique for Streptococcus, group A (strep)",101.0,50.5,10.73,137.36,32
HCPCS,87449,Detection test by immunoassay technique for other organism,138.0,69.0,10.73,187.68,256
HCPCS,87476,"Detection by nucleic acid for borrelia burgdorferi (bacteria), amplified probe technique",325.0,162.5,41.79,442.0,32
HCPCS,87483,Test for detecting nucleic acid of organism causing infection of central nervous system,719.0,359.5,23.44,2996.65,32
HCPCS,87486,"Detection test by nucleic acid for Chlamydia pneumoniae, amplified probe technique",130.0,65.0,41.79,176.8,32
HCPCS,87491,"Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique",165.0,82.5,41.79,224.4,32
HCPCS,87493,"Detection test by nucleic acid for clostridium difficile, amplified probe technique",151.0,75.5,43.62,205.36,32
HCPCS,87496,"Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique",302.0,151.0,41.79,410.72,32
HCPCS,87497,"Detection test by nucleic acid for cytomegalovirus, quantification",333.0,166.5,43.62,452.88,32
HCPCS,87498,"Detection test by nucleic acid for enterovirus (intestinal virus), amplified probe technique",145.0,72.5,41.79,197.2,32
HCPCS,87502,Detection test by nucleic acid for multiple types influenza virus,259.0,129.5,82.88,352.24,32
HCPCS,87507,"Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets",1182.0,591.0,207.57,4926.34,32
HCPCS,87517,"Detection test by nucleic acid for Hepatitis B virus, quantification",326.0,163.0,43.62,443.36,32
HCPCS,87521,"Detection test by nucleic acid for Hepatitis C virus, amplified probe technique",163.0,81.5,41.79,221.68,32
HCPCS,87522,"Detection test by nucleic acid for Hepatitis C virus, quantification",385.0,192.5,43.62,523.6,32
HCPCS,87529,"Detection test by nucleic acid for herpes simplex virus, amplified probe technique",303.0,151.5,41.79,412.08,96
HCPCS,87530,"Detection test by nucleic acid for herpes simplex virus, quantification",322.0,161.0,43.62,437.92,32
HCPCS,87533,"Detection test by nucleic acid for herpes virus-6, quantification",145.0,72.5,43.62,197.2,32
HCPCS,87535,"Detection test by nucleic acid for HIV-1 virus, amplified probe technique",337.0,168.5,41.79,458.32,32
HCPCS,87536,"Detection test by nucleic acid for HIV-1 virus, quantification",524.0,262.0,43.62,712.64,32
HCPCS,87538,"Detection test by nucleic acid for HIV-2 virus, amplified probe technique",106.0,53.0,37.2,144.16,32
HCPCS,87556,"Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), amplified probe technique",396.0,198.0,41.79,538.56,32
HCPCS,87563,Detection of Mycoplasma genitalium by DNA or RNA probe,122.0,61.0,36.6,165.92,32
HCPCS,87581,"Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified probe technique",130.0,65.0,41.79,176.8,32
HCPCS,87591,"Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique",157.0,78.5,41.79,213.52,32
HCPCS,87593,Detection of orthopoxvirus,193.0,96.5,43.62,262.48,32
HCPCS,87624,"Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types",188.0,94.0,43.62,255.68,64
HCPCS,87625,"Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only",146.0,73.0,43.62,198.56,32
HCPCS,87632,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 6-11 targets",809.0,404.5,207.57,1764.11,32
HCPCS,87633,"Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 12-25 targets",1072.0,536.0,207.57,4467.88,32
HCPCS,87635,Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen,272.0,136.0,43.62,369.92,96
HCPCS,87637,"Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19), influenza virus types A and B, and respiratory syncytial virus",514.0,257.0,43.62,733.12,64
HCPCS,87641,"Detection test by nucleic acid for Staphylococcus aureus, methicillin resistant (MRSA bacteria), amplified probe technique",204.0,102.0,41.79,277.44,32
HCPCS,87651,"Detection test by nucleic acid for Strep (Streptococcus, group A), amplified probe technique",127.0,63.5,41.79,172.72,32
HCPCS,87653,"Detection test by nucleic acid for Strep (Streptococcus, group B), amplified probe technique",122.0,61.0,39.04,165.92,32
HCPCS,87661,"Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique",162.0,81.0,23.44,220.32,32
HCPCS,87662,"Detection test by nucleic acid for Zika virus, amplified probe technique",177.0,88.5,43.62,240.72,32
HCPCS,87798,"Detection test by nucleic acid for organism, amplified probe technique",120.5,60.25,38.95,176.8,384
HCPCS,87799,"Detection test by nucleic acid for organism, quantification",600.0,300.0,43.62,1020.0,128
HCPCS,87801,"Detection test by nucleic acid for multiple organisms, amplified probe(s) technique",277.0,138.5,43.62,376.72,128
HCPCS,87808,Detection test by immunoassay with direct visual observation for Trichomonas vaginal (genital parasite),92.0,46.0,10.73,125.12,32
HCPCS,87899,Detection test by immunoassay with direct visual observation for other organism,115.0,57.5,10.73,156.4,32
HCPCS,87901,Analysis test by nucleic acid for HIV-1 virus,895.0,447.5,167.65,2304.18,32
HCPCS,87902,Analysis test by nucleic acid for Hepatitis C virus,813.0,406.5,167.65,2093.07,32
HCPCS,88104,"Cell examination of body fluid, smears",231.0,115.5,33.44,314.16,32
HCPCS,88108,"Cell examination of specimen, concentration technique",250.0,125.0,33.44,340.0,32
HCPCS,88112,"Cell examination of specimen, selective cellular enhancement technique",283.0,141.5,33.44,384.88,32
HCPCS,88142,"Pap test, manual screening",149.0,74.5,5.66,202.64,32
HCPCS,88160,"Screening examination of specimen cells, screening and interpretation",199.0,99.5,33.44,270.64,32
HCPCS,88172,Evaluation of fine needle aspirate,567.0,283.5,37.0,771.12,32
HCPCS,88173,Evaluation of fine needle aspirate with interpretation and report,630.0,315.0,67.1,856.8,32
HCPCS,88175,"Pap test, automated thin layer preparation; automated system and manual rescreening",161.0,80.5,20.82,218.96,32
HCPCS,88177,"Pap test, evaluation of fine needle aspirate, immediate, each additional evaluation episode",153.0,76.5,13.65,208.08,32
HCPCS,88182,Flow cytometry technique for DNA or cell analysis,549.0,274.5,33.44,746.64,32
HCPCS,88184,"Flow cytometry technique for DNA or cell analysis, first marker",1167.0,583.5,108.05,1587.12,32
HCPCS,88185,"Flow cytometry technique for DNA or cell analysis, each additional marker",150.0,75.0,33.44,204.0,32
HCPCS,88187,"Flow cytometry technique for DNA or cell analysis, 2 to 8 markers",594.0,297.0,33.44,807.84,32
HCPCS,88230,Tissue culture to identify white blood cell disorders,676.0,338.0,185.49,919.36,32
HCPCS,88237,Tissue culture for tumor disorders of bone marrow and blood cells,1011.0,505.5,185.49,1453.31,32
HCPCS,88240,"Cryopreservation, freezing and storage of cells",486.0,243.0,5.05,660.96,32
HCPCS,88262,"Chromosome analysis for genetic defects, count 15-20 cells",1017.0,508.5,47.41,1383.12,32
HCPCS,88271,DNA testing for genetic defects,179.0,89.5,17.32,243.44,160
HCPCS,88273,"Chromosome analysis for genetic defects, analyze 10-30 cells",775.0,387.5,38.73,1054.0,32
HCPCS,88274,"Chromosome analysis for genetic defects, analyze 25-99 cells",538.0,269.0,41.79,731.68,32
HCPCS,88275,"Chromosome analysis for genetic defects, analyze 100-300 cells",554.0,277.0,47.41,753.44,32
HCPCS,88300,"Pathology examination of tissue using a microscope, limited examination",121.0,60.5,20.11,164.56,32
HCPCS,88302,Pathology examination of tissue using a microscope,278.0,139.0,31.6,378.08,32
HCPCS,88304,"Pathology examination of tissue using a microscope, moderately low complexity",530.0,265.0,40.47,720.8,32
HCPCS,88305,"Pathology examination of tissue using a microscope, intermediate complexity",542.0,271.0,40.47,737.12,32
HCPCS,88307,"Pathology examination of tissue using a microscope, moderately high complexity",1167.0,583.5,165.12,1587.12,64
HCPCS,88309,"Pathology examination of tissue using a microscope, high complexity",1654.0,827.0,165.12,2795.44,32
HCPCS,88311,Preparation of tissue for examination by removing any calcium present,93.0,46.5,8.16,126.48,32
HCPCS,88312,Special stained specimen slides to identify organisms including interpretation and report,186.0,93.0,40.47,252.96,32
HCPCS,88313,Special stained specimen slides to examine tissue including interpretation and report,270.0,135.0,24.47,367.2,32
HCPCS,88321,Surgical pathology consultation and report on referred slides prepared elsewhere,274.0,137.0,48.09,372.64,32
HCPCS,88323,Surgical pathology consultation and report on referred material requiring preparation of slides,268.0,134.0,67.1,364.48,32
HCPCS,88331,"Pathology examination of specimen during surgery, first tissue block",567.0,283.5,40.78,771.12,32
HCPCS,88332,"Pathology examination of specimen during surgery, each additional tissue block",191.0,95.5,14.27,259.76,32
HCPCS,88333,"Pathology cytologic examination of specimen during surgery, initial site",1654.0,827.0,43.83,2795.44,32
HCPCS,88334,"Pathology cytologic examination of specimen during surgery, each additional site",158.0,79.0,26.5,214.88,32
HCPCS,88341,"Special stained specimen slides to examine tissue, each additional procedure",273.0,136.5,40.47,371.28,32
HCPCS,88342,"Special stained specimen slides to examine tissue, initial procedure",567.0,283.5,90.83,771.12,96
HCPCS,88344,"Special stained specimen slides to examine tissue, each multiplex procedure",1167.0,583.5,90.83,1587.12,32
HCPCS,88346,"Antibody evaluation, initial single antibody stain procedure",1167.0,583.5,78.49,1587.12,64
HCPCS,88348,Electron microscopy for diagnosis,2553.0,1276.5,165.12,3472.08,32
HCPCS,88350,"Antibody evaluation, each additional single antibody stain procedure",403.0,201.5,40.47,548.08,32
HCPCS,88360,"Microscopic genetic analysis of tumor, manual",567.0,283.5,89.71,771.12,64
HCPCS,88361,"Microscopic genetic analysis of tumor, using computer-assisted technology",596.0,298.0,129.46,1166.8,32
HCPCS,88364,"Genetic sequencing localization, each additional procedure",395.0,197.5,40.47,537.2,32
HCPCS,88365,"Genetic sequencing localization, initial procedure",567.0,283.5,133.54,771.12,64
HCPCS,88377,"Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure",958.0,479.0,165.12,1302.88,64
HCPCS,88387,"Pathologist examination, dissection, and preparation of tissue",88.0,44.0,17.5,119.68,32
HCPCS,88720,Measurement of bilirubin,32.0,16.0,1.61,43.52,32
HCPCS,89051,Body fluid cell count with cell identification,111.0,55.5,5.05,150.96,32
HCPCS,89055,"White blood cell measure, stool specimen",82.0,41.0,3.5,111.52,32
HCPCS,89060,Crystal identification from tissue or body fluid,97.0,48.5,5.05,131.92,32
HCPCS,89220,Sputum specimen collection,561.0,280.5,21.41,762.96,32
HCPCS,89230,Sweat collection,414.0,207.0,10.36,563.04,64
HCPCS,89240,Pathology tests,816.0,408.0,33.44,1109.76,32
HCPCS,89250,"Culture of eggs or embryos, less than 4 days",2331.0,1165.5,122.22,3170.16,32
HCPCS,89253,Assisted embryo hatching (fertility procedure),1301.0,650.5,122.22,1769.36,32
HCPCS,89254,Egg identification from ovarian fluid,1090.0,545.0,122.22,1482.4,32
HCPCS,89255,Preparation of embryo for transfer,371.0,185.5,67.1,504.56,32
HCPCS,89258,Frozen preservation of embryos,1277.0,638.5,122.22,2795.44,32
HCPCS,89259,Frozen preservation of sperm,567.0,283.5,122.22,771.12,32
HCPCS,89260,Sperm isolation with semen analysis for fertilization or diagnosis,349.0,174.5,67.1,474.64,32
HCPCS,89261,Sperm isolation and semen analysis for fertilization or diagnosis,451.0,225.5,67.1,613.36,32
HCPCS,89264,Sperm identification from testis tissue,1026.0,513.0,67.1,1395.36,32
HCPCS,89272,"Extended culture of eggs or embryos, 4-7 days",2010.0,1005.0,122.22,2795.44,32
HCPCS,89280,"Assisted oocyte fertilization (fertility procedure), less than or equal to 10 oocytes",3582.0,1791.0,122.22,4871.52,32
HCPCS,89281,"Assisted oocyte fertilization (fertility procedure), greater than 10 oocytes",3917.0,1958.5,122.22,5327.12,32
HCPCS,89290,"Biopsy of egg or embryo for pre-implantation genetic diagnosis, less than or equal to 5 embryos",1530.0,765.0,122.22,2080.8,32
HCPCS,89291,"Biopsy of egg or embryo for pre-implantation genetic diagnosis, greater than 5 embryos",1935.0,967.5,122.22,2631.6,32
HCPCS,89310,Semen analysis motility and count,278.0,139.0,5.05,378.08,32
HCPCS,89320,"Semen evaluation volume, sperm count, motility and analysis",251.0,125.5,5.05,341.36,32
HCPCS,89321,Semen analysis for sperm presence,255.0,127.5,5.05,346.8,64
HCPCS,89335,Frozen preservation of male reproductive tissue,679.0,339.5,67.1,923.44,32
HCPCS,89343,Storage of sperm or semen per year,268.0,134.0,85.76,566.1,32
HCPCS,89346,"Storage of eggs, per year",268.0,134.0,85.76,1166.8,64
HCPCS,89352,Thawing of frozen embryos,686.0,343.0,122.22,932.96,32
HCPCS,89353,Thawing of frozen sperm or semen,182.0,91.0,58.24,247.52,32
HCPCS,89356,Thawing of frozen eggs,816.0,408.0,122.22,1109.76,32
HCPCS,89398,Reproductive medicine laboratory procedure,186.0,93.0,33.44,252.96,32
HCPCS,90371,Hepatitis B immune globulin for injection into muscle,878.0,439.0,227.42,1286.64,31
HCPCS,90377,Rabies immune globulin for injection beneath the skin and/or into muscle,149.0,74.5,39.24,1677.59,31
HCPCS,90380,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
HCPCS,90381,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
HCPCS,90471,Administration of vaccine,149.0,74.5,44.7,202.64,288
HCPCS,90472,"Administration of vaccine, each additional vaccine",120.0,60.0,36.0,163.2,64
HCPCS,90480,"Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose",120.0,60.0,36.0,163.2,32
HCPCS,90620,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",713.625,356.815,38.9,7389.48,32
HCPCS,90632,Hepatitis A vaccine adult dosage,243.0,121.5,26.68,330.48,32
HCPCS,90636,Hepatitis A and hepatitis B vaccine,404.0,202.0,121.2,549.44,32
HCPCS,90648,"Haemophilus influenzae type b vaccine, PRP-T conjugate",122.15,61.07,26.68,178.23,64
HCPCS,90649,"Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent",499.0,249.5,141.24,678.64,32
HCPCS,90651,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",759.18,379.59,56.4,1039.04,96
HCPCS,90653,"Influenza vaccine, inactivated",138.115,69.055,26.68,303.28,64
HCPCS,90656,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",122.9,61.45,17.4,162.0,64
HCPCS,90661,"Influenza vaccine, trivalent, derived from cell cultures, antibiotic free, 0.5 mL dosage, for intramuscular use",85.0,42.5,25.5,115.6,32
HCPCS,90670,"Pneumococcal vaccine, 13-valent",565.0,282.5,65.1,1141.23,64
HCPCS,90675,Rabies vaccine for injection into muscle,744.69,372.34,34.8,1823.64,62
HCPCS,90677,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",125.515,62.760000000000005,37.13,898.96,64
HCPCS,90678,"Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use",766.0,383.0,26.68,1041.76,32
HCPCS,90679,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",766.0,383.0,26.68,1433.19,64
HCPCS,90683,Respiratory syncytial virus vaccine mRNA lipid nanoparticles,923.0,461.5,276.9,1255.28,28
HCPCS,90684,"Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use",1091.0,545.5,322.28,1483.76,28
HCPCS,90686,"Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage",65.0,32.5,0.5,88.4,32
HCPCS,90691,Typhoid vaccine for injection into muscle,332.0,166.0,26.68,451.52,32
HCPCS,90700,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",104.36,52.18,26.62,128.16,32
HCPCS,90707,"Measles, mumps, and rubella vaccine",175.1,87.55,26.68,397.12,64
HCPCS,90713,Poliovirus vaccine,124.83,62.42,26.68,218.47,32
HCPCS,90715,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",134.5,67.25,26.68,428.4,64
HCPCS,90716,Varicella vaccine,310.44,155.22,58.56,648.72,32
HCPCS,90723,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",215.17,107.58,26.68,316.88,32
HCPCS,90732,"Pneumococcal vaccine, 23-valent",276.0,138.0,26.68,395.76,64
HCPCS,90734,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",227.99,114.0,36.0,860.63,96
HCPCS,90739,"Hepatitis B vaccine (HepB), CpG-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use",404.0,202.0,26.68,549.44,32
HCPCS,90744,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",183.0,91.5,26.68,316.88,32
HCPCS,90746,"Hepatitis B vaccine, adult dosage (3 dose schedule)",127.25,63.63,26.68,307.36,64
HCPCS,90750,Shingles vaccine for injection into muscle,606.0,303.0,38.9,962.65,60
HCPCS,90785,Psychiatric services complicated by communication factor,202.0,101.0,60.6,274.72,30
HCPCS,90791,Psychiatric diagnostic evaluation,362.5,181.25,27.0,863.6,122
HCPCS,90792,Psychiatric diagnostic evaluation with medical services,685.0,342.5,205.5,931.6,92
HCPCS,90832,"Psychotherapy, 30 minutes",395.0,197.5,118.5,537.2,30
HCPCS,90833,"Psychotherapy with evaluation and management visit, 30 minutes",455.0,227.5,136.5,618.8,30
HCPCS,90834,"Psychotherapy, 45 minutes",274.5,137.25,15.6,675.92,60
HCPCS,90836,"Psychotherapy with evaluation and management visit, 45 minutes",497.0,248.5,149.1,675.92,30
HCPCS,90837,"Psychotherapy, 1 hour",516.0,258.0,154.8,701.76,30
HCPCS,90838,"Psychotherapy with evaluation and management visit, 1 hour",500.0,250.0,150.0,680.0,60
HCPCS,90839,"Psychotherapy for crisis, first hour",938.0,469.0,193.96,1275.68,30
HCPCS,90840,"Psychotherapy for crisis, each additional 30 minutes",280.0,140.0,84.0,380.8,30
HCPCS,90846,"Family psychotherapy without patient, 50 minutes",495.0,247.5,148.5,673.2,30
HCPCS,90847,"Family psychotherapy with patient, 50 minutes",516.0,258.0,154.8,701.76,30
HCPCS,90853,Group psychotherapy,594.0,297.0,104.7,1141.04,90
HCPCS,90867,"Treatment using magnetic field to stimulate nerve cells in brain, initial delivery and management",839.0,419.5,251.7,1141.04,32
HCPCS,90868,"Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management",1013.0,506.5,278.02,1377.68,32
HCPCS,90870,Therapy using electrical currents,1576.0,788.0,472.8,2143.36,30
HCPCS,90935,Hemodialysis procedure with physician evaluation,2092.5,1046.25,505.5,3400.0,128
HCPCS,90945,Dialysis procedure including 1 evaluation,3330.0,1665.0,537.27,4528.8,160
HCPCS,91010,Study of esophagus to assess movement,2488.0,1244.0,480.47,3383.68,32
HCPCS,91034,Monitoring and recording of esophageal function through nasal tube,2395.0,1197.5,480.47,3257.2,32
HCPCS,91035,Monitoring and recording of esophageal function through a capsule attached to the esophagus wall,2628.0,1314.0,488.25,3574.08,32
HCPCS,91040,Study of esophageal sensation by balloon distension,7030.0,3515.0,480.47,9560.8,32
HCPCS,91065,Measurement of hydrogen in breath to test for stomach and bowel symptoms,1775.0,887.5,69.31,2414.0,32
HCPCS,91110,Imaging of digestive tract done from the inside of the digestive tract,4738.0,2369.0,488.25,6443.68,32
HCPCS,91200,Measurement of liver stiffness,558.0,279.0,137.18,758.88,32
HCPCS,91299,Other diagnostic procedure for gastrointestine,2955.0,1477.5,165.68,4018.8,32
HCPCS,91320,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use",428.0,214.0,26.68,582.08,32
HCPCS,91322,"Severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use",367.0,183.5,26.68,499.12,32
HCPCS,92025,CT scan of cornea,281.0,140.5,70.21,382.16,32
HCPCS,92081,Exam of visual field with limited testing,272.0,136.0,75.96,369.92,32
HCPCS,92082,Exam of visual field with intermediate testing,359.0,179.5,75.96,488.24,32
HCPCS,92083,Exam of visual field with extended testing,430.0,215.0,94.55,584.8,32
HCPCS,92132,Imaging of front third of eye,372.0,186.0,70.21,505.92,32
HCPCS,92133,Imaging of optic nerve,340.0,170.0,70.21,462.4,32
HCPCS,92134,Imaging of retina,358.0,179.0,70.21,486.88,32
HCPCS,92137,Imaging of retina with optical coherence tomography angiography,934.0,467.0,278.02,1270.24,28
HCPCS,92235,Exam of retinal blood vessels using a special camera after injection of a dye,1005.0,502.5,278.02,1366.8,32
HCPCS,92240,Exam of blood vessels between the white part of eye and retina using a special camera after injection of a dye,777.0,388.5,233.1,1056.72,32
HCPCS,92242,Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye,979.0,489.5,278.02,1331.44,32
HCPCS,92250,Photography of the retina,578.0,289.0,70.21,786.08,32
HCPCS,92273,Measurement of retinal and optic nerve function,864.0,432.0,94.55,1175.04,32
HCPCS,92274,Measurement of retinal and optic nerve function targeting multiple separate locations,590.0,295.0,94.55,802.4,32
HCPCS,92284,Evaluation of eye adaptation to light and dark with interpretation and report,980.0,490.0,94.55,1332.8,32
HCPCS,92285,Photography of content of eyes,370.0,185.0,48.09,503.2,32
HCPCS,92286,Imaging of front third of eye using a special microscope,620.0,310.0,70.21,843.2,32
HCPCS,92504,Exam of ear using a microscope,241.0,120.5,72.3,327.76,28
HCPCS,92507,"Treatment of speech, language, voice, communication, and/or hearing processing disorder",514.0,257.0,47.09,699.04,32
HCPCS,92508,"Treatment of speech, language, voice, communication, and/or hearing processing disorder in a group setting",368.0,184.0,24.31,500.48,32
HCPCS,92511,Exam of the nose and throat using an endoscope,691.0,345.5,207.3,939.76,32
HCPCS,92521,"Evaluation of speech continuity, smoothness, rate, and effort",590.0,295.0,76.25,802.4,32
HCPCS,92522,Evaluation of speech sound production,540.0,270.0,76.25,734.4,32
HCPCS,92523,Evaluation of speech sound production with evaluation of language comprehension and expression,576.0,288.0,76.25,783.36,32
HCPCS,92524,Analysis of voice and resonance production,544.0,272.0,76.25,739.84,32
HCPCS,92526,Treatment of swallowing and feeding disorder,544.0,272.0,45.25,739.84,32
HCPCS,92537,Test to assess balance during warm and cool irrigation in both ears,870.0,435.0,165.68,1183.2,32
HCPCS,92538,Test to assess balance during warm or cool irrigation in both ears,821.0,410.5,172.78,1116.56,32
HCPCS,92540,Evaluation and testing for balance with recording,1250.0,625.0,172.78,1700.0,32
HCPCS,92541,Test for abnormal eye movement with recording,345.0,172.5,38.31,469.2,32
HCPCS,92544,Test for abnormal eye movement using a moving target with recording,506.0,253.0,38.31,688.16,32
HCPCS,92545,Test for abnormal eye movement using a moving target that moves back and forth with recording,629.0,314.5,38.31,855.44,32
HCPCS,92550,Test for eardrum and muscle function,437.0,218.5,100.23,594.32,32
HCPCS,92551,Test for screening hearing,167.0,83.5,38.31,227.12,32
HCPCS,92552,Test for hearing various pitches using earphone,259.0,129.5,38.31,352.24,32
HCPCS,92553,Test for hearing various pitches using earphone and device placed against the bone,419.0,209.5,100.23,569.84,32
HCPCS,92555,Test for ability to detect and repeat spoken words,207.0,103.5,38.31,281.52,32
HCPCS,92556,Test for ability to detect and repeat spoken words with speech recognition,205.0,102.5,38.31,278.8,32
HCPCS,92557,Comprehensive hearing and speech recognition test,508.0,254.0,100.23,690.88,32
HCPCS,92558,Test for screening hearing using a probe,753.0,376.5,38.31,1024.08,32
HCPCS,92565,Test to assess hearing loss,178.0,89.0,38.31,242.08,32
HCPCS,92567,Test to assess middle ear function,280.0,140.0,38.31,380.8,32
HCPCS,92568,Test to assess middle ear muscle reflex,174.0,87.0,38.31,236.64,32
HCPCS,92570,Comprehensive hearing test,552.0,276.0,100.23,750.72,32
HCPCS,92579,Test to assess hearing sensitivity using visual aids,443.0,221.5,100.23,602.48,32
HCPCS,92582,Test to assess hearing sensitivity using activity related feedback,491.0,245.5,100.23,667.76,32
HCPCS,92583,Test to assess hearing using pictures,207.0,103.5,38.31,281.52,32
HCPCS,92584,Test to assess electrical potentials generated in the inner ear as a result of sound stimulation,897.0,448.5,100.23,1219.92,32
HCPCS,92587,Placement of ear probe for computerized measurement of sound with interpretation and report,650.0,325.0,100.23,884.0,32
HCPCS,92588,Placement of ear probe for computerized measurement of repeated sounds with interpretation and report,886.0,443.0,100.23,1204.96,32
HCPCS,92597,Evaluation for use of voice artificial device to supplement oral speech,638.0,319.0,73.43,867.68,32
HCPCS,92601,Analysis and programming of inner ear implant (younger than 7 years),506.0,253.0,45.43,688.16,32
HCPCS,92602,Analysis and reprogramming of inner ear implant (younger than 7 years),482.0,241.0,45.43,655.52,32
HCPCS,92603,Analysis and programming of inner ear implant (7 years or older),561.0,280.5,45.43,762.96,32
HCPCS,92604,Analysis and reprogramming of inner ear implant (7 years or older),493.0,246.5,45.43,670.48,32
HCPCS,92607,"Evaluation with prescription of speech-generating and alternative communication device, first hour",374.0,187.0,112.2,508.64,32
HCPCS,92610,Evaluation of swallowing function,638.0,319.0,71.1,867.68,32
HCPCS,92611,Evaluation of swallowing function image,684.0,342.0,91.91,930.24,32
HCPCS,92612,Evaluation and recording of swallowing using an endoscope,775.0,387.5,66.47,1054.0,32
HCPCS,92622,"Analysis, programming, and verification of sound processor for bone-anchored inner ear implant, first hour",425.0,212.5,127.5,578.0,28
HCPCS,92626,"Evaluation of hearing function related to surgically implanted hearing device, first hour",575.0,287.5,165.68,782.0,32
HCPCS,92627,"Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes",221.0,110.5,66.3,303.05,32
HCPCS,92651,Evaluation of brain response to sound for determination of hearing status with interpretation and report,650.0,325.0,100.23,884.0,32
HCPCS,92652,Evaluation of brain response to sound for determination of hearing threshold with interpretation and report,983.0,491.5,100.23,1336.88,32
HCPCS,92920,Balloon dilation of single coronary artery or branch,14942.0,7471.0,4482.6,20321.12,32
HCPCS,92924,Removal of plaque with balloon dilation of single coronary artery or branch,20832.0,10416.0,6249.6,28331.52,32
HCPCS,92928,"Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch",19505.0,9752.5,5851.5,26526.8,32
HCPCS,92933,"Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch",28118.0,14059.0,8435.4,38240.48,32
HCPCS,92937,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary vessel with distal protection",19505.0,9752.5,5851.5,26526.8,32
HCPCS,92941,"Removal of plaque and blood clot, insertion of stent and/or balloon dilation of single vessel",18506.0,9253.0,5551.8,25168.16,32
HCPCS,92943,"Removal of plaque, insertion of stent and/or balloon dilation of single coronary artery, branch or bypass graft",19505.0,9752.5,5851.5,26526.8,32
HCPCS,92950,Manual attempt to restore blood circulation and breathing,1374.0,687.0,278.02,1868.64,96
HCPCS,92953,Temporary pacemaker to regulate heart beat,1930.0,965.0,579.0,2624.8,32
HCPCS,92960,External shock to heart to regulate heart beat,2956.0,1478.0,777.75,4020.16,96
HCPCS,92972,Shockwave destruction of calcified plaque in coronary artery accessed through skin using catheter,7095.0,3547.5,2128.5,9649.2,28
HCPCS,92973,Removal of blood clot in heart artery,4000.0,2000.0,1200.0,10909.9,32
HCPCS,92978,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel",6944.0,3472.0,253.72,9443.84,32
HCPCS,92979,"Ultrasound evaluation of heart blood vessel or graft with review by radiologist, each additional vessel",3817.0,1908.5,253.72,5191.12,32
HCPCS,92986,Balloon dilation repair of aortic valve,9310.0,4655.0,2793.0,12661.6,32
HCPCS,92987,Balloon dilation repair of mitral valve,19897.0,9948.5,5969.1,27059.92,32
HCPCS,92990,Balloon dilation repair of pulmonary valve,17909.0,8954.5,5372.7,24356.24,32
HCPCS,92997,"Balloon dilation of pulmonary artery, single vessel",17732.0,8866.0,5319.6,24115.52,32
HCPCS,93005,Routine electrocardiogram (ECG) using at least 12 leads with tracing,453.0,226.5,32.27,616.08,96
HCPCS,93017,Exercise or drug-induced heart stress test with electrocardiogram (ECG),1750.0,875.0,139.84,2380.0,32
HCPCS,93041,Electrocardiogram (ECG) 1 to 3 leads,217.0,108.5,31.44,295.12,32
HCPCS,93225,Electrocardiogram (ECG) 2-day continuous,1162.0,581.0,77.51,1580.32,32
HCPCS,93242,Heart rhythm recording continuous external EKG over more than 48 hours up to 7 days,897.0,448.5,48.09,1219.92,32
HCPCS,93246,Heart rhythm recording of continuous external EKG over 8-15 days,900.0,450.0,48.09,1224.0,32
HCPCS,93260,Programming of implantable defibrillator system,300.0,150.0,45.43,408.0,32
HCPCS,93261,Evaluation of implantable defibrillator system,280.0,140.0,45.43,380.8,32
HCPCS,93270,Electrocardiogram (ECG) up to 30 days continuous with symptom monitoring,629.0,314.5,48.05,855.44,32
HCPCS,93279,Programming of single lead pacemaker system,421.0,210.5,45.43,572.56,32
HCPCS,93280,Programming of dual lead pacemaker system,488.0,244.0,45.43,663.68,32
HCPCS,93281,Programming of multiple lead pacemaker system,496.0,248.0,45.43,674.56,32
HCPCS,93282,Programming of single lead implantable defibrillator system,874.0,437.0,45.43,1188.64,32
HCPCS,93283,Programming of dual lead implantable defibrillator system,961.0,480.5,45.43,1306.96,32
HCPCS,93284,Programming of multiple lead implantable defibrillator system,1030.0,515.0,45.43,1400.8,32
HCPCS,93285,Programming of cardiac rhythm monitor system,388.0,194.0,45.43,527.68,32
HCPCS,93286,"Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery",300.0,150.0,45.43,408.0,32
HCPCS,93287,"Programming of single, dual or multiple lead implantable defibrillator system before or after surgery",410.0,205.0,45.43,557.6,32
HCPCS,93288,"Evaluation of single, dual, multiple lead or leadless pacemaker system",612.0,306.0,45.43,832.32,32
HCPCS,93289,"Evaluation of single, dual, or multiple lead implantable defibrillator system",650.0,325.0,45.43,884.0,32
HCPCS,93291,Evaluation of cardiac rhythm monitor system,602.0,301.0,37.24,818.72,32
HCPCS,93296,"Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days",575.0,287.5,45.43,782.0,32
HCPCS,93298,"Evaluation of cardiac rhythm monitor system, remote up to 30 days",369.0,184.5,48.05,501.84,32
HCPCS,93303,Ultrasound of heart for congenital defect,2892.0,1446.0,543.5,3933.12,32
HCPCS,93304,"Ultrasound of heart for congenital defect, follow-up",1720.0,860.0,516.0,2339.2,32
HCPCS,93306,"Ultrasound of heart with color-depicted blood flow, rate, direction and valve function",4000.0,2000.0,543.5,5440.0,32
HCPCS,93307,Ultrasound of heart,1703.0,851.5,190.8,2316.08,32
HCPCS,93308,"Ultrasound of heart, follow-up",889.0,444.5,116.62,1209.04,64
HCPCS,93312,"Ultrasound of heart with probe in esophagus, with report",3054.0,1527.0,343.57,4153.44,32
HCPCS,93314,Interpretation and report of ultrasound of heart,2602.0,1301.0,543.5,3538.72,32
HCPCS,93315,"Ultrasound of heart with probe in esophagus for congenital defect, with report",2573.0,1286.5,543.5,3499.28,32
HCPCS,93320,"Ultrasound of heart blood flow, valves and chambers",1082.0,541.0,103.38,1471.52,32
HCPCS,93321,"Ultrasound of heart blood flow, valves and chambers, follow-up",810.0,405.0,88.84,1101.6,32
HCPCS,93325,"Ultrasound of heart with color-depicted blood flow, rate and valve function",960.0,480.0,65.17,1305.6,32
HCPCS,93350,"Ultrasound of heart during rest, exercise and/or drug-induced stress with report",1718.0,859.0,234.85,2336.48,32
HCPCS,93351,"Ultrasound of heart with continuous electrocardiogram (ECG) during rest, exercise and/or drug induced stress with review and report",5500.0,2750.0,543.5,7480.0,32
HCPCS,93355,Ultrasound of heart with probe in esophagus during surgery on heart or great blood vessels with report,5038.0,2519.0,543.5,6851.68,32
HCPCS,93356,Heart muscle strain imaging,998.0,499.0,299.4,1357.28,32
HCPCS,93451,Insertion of tube in right heart chambers for measurement,13125.0,6562.5,3027.8,17850.0,32
HCPCS,93452,Insertion of tube in left heart chambers for diagnosis with review by radiologist,14375.0,7187.5,3027.8,19550.0,32
HCPCS,93453,Insertion of tube in right and left heart chambers for diagnosis with review by radiologist,13825.0,6912.5,3027.8,18802.0,32
HCPCS,93454,Insertion of tube in coronary artery for diagnosis with review by radiologist,11501.0,5750.5,3027.8,15641.36,32
HCPCS,93455,Insertion of tube in bypass graft for diagnosis with review by radiologist,12621.0,6310.5,3027.8,17164.56,32
HCPCS,93456,Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist,15950.0,7975.0,3027.8,21692.0,32
HCPCS,93457,"Insertion of tube in right heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",19228.0,9614.0,3027.8,26150.08,32
HCPCS,93458,Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist,18463.0,9231.5,3027.8,25109.68,32
HCPCS,93459,"Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist",19435.0,9717.5,3027.8,26431.6,32
HCPCS,93460,Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist,15015.0,7507.5,3027.8,20420.4,32
HCPCS,93461,"Insertion of tube in right and left heart chambers, coronary artery, and bypass graft for diagnosis with review by radiologist",16556.0,8278.0,3027.8,22516.16,32
HCPCS,93462,Insertion of tube in left heart chamber through heart septum,12994.0,6497.0,3027.8,17671.84,32
HCPCS,93463,Drug infusion during cardiac catheterization,1814.0,907.0,58.14,2467.04,32
HCPCS,93503,Insertion of tube in pulmonary artery for monitoring,2429.0,1214.5,728.7,3303.44,64
HCPCS,93505,Biopsy of heart muscle,6984.0,3492.0,2095.2,9498.24,32
HCPCS,93563,Injection for imaging of coronary blood vessel during evaluation of congenital abnormalities with review by radiologist,3141.0,1570.5,411.09,4271.76,32
HCPCS,93566,Injection for imaging of right heart chambers with review by radiologist,1581.0,790.5,411.09,2150.16,32
HCPCS,93567,Injection for imaging of aorta above heart valve with review by radiologist,2517.0,1258.5,411.09,3423.12,32
HCPCS,93568,Injection for nonselective imaging of pulmonary artery during heart catheterization,2850.0,1425.0,411.09,3876.0,32
HCPCS,93569,"Injection for selective imaging of pulmonary artery during heart catheterization, on one side of body",1814.0,907.0,411.09,2467.04,32
HCPCS,93571,"Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel",4694.0,2347.0,1408.2,6383.84,32
HCPCS,93573,"Injection for selective imaging of pulmonary artery during heart catheterization, on both sides of body",2993.0,1496.5,411.09,4070.48,32
HCPCS,93580,Repair of congenital abnormality in wall between upper heart chambers with implant,31250.0,15625.0,9375.0,42500.0,32
HCPCS,93581,Repair of congenital abnormality in wall between lower heart chambers with implant,28359.0,14179.5,8507.7,38568.24,32
HCPCS,93582,Repair of congenital abnormality of pulmonary artery to aorta,28078.0,14039.0,8423.4,38186.08,32
HCPCS,93587,Review by radiologist of vein imaging for congenital heart defect of venovenous collaterals above the heart,3835.0,1917.5,1150.5,5215.6,28
HCPCS,93590,"Repair of leak adjacent to mitral valve, first closure device",42203.0,21101.5,12660.9,57396.08,32
HCPCS,93591,"Repair of leak adjacent to aortic valve, first closure device",34848.0,17424.0,10454.4,47393.28,32
HCPCS,93592,"Repair of lead adjacent to heart valve, each additional closure device",29335.0,14667.5,8800.5,39895.6,32
HCPCS,93593,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",10500.0,5250.0,3027.8,14280.0,32
HCPCS,93594,"Insertion of catheter into right side of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",13058.0,6529.0,3027.8,17758.88,32
HCPCS,93596,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with abnormal native blood vessel connections, using imaging guidance",12250.0,6125.0,3027.8,16660.0,32
HCPCS,93597,"Insertion of catheter into right and left sides of heart for evaluation of congenital heart defect in heart with normal native blood vessel connections, using imaging guidance",14812.0,7406.0,3027.8,20144.32,32
HCPCS,93603,Recording of right lower heart chamber rhythm,2500.0,1250.0,750.0,8475.93,32
HCPCS,93609,Insertion of tube in upper and/or lower heart chambers to record and identify origin of abnormal heart rhythm,7261.0,3630.5,971.89,23251.95,32
HCPCS,93613,Insertion of tube for 3D mapping of electrical impulses to heart muscle,13657.0,6828.5,4097.1,18573.52,32
HCPCS,93620,Insertion of catheters for recording and pacing of right heart chambers rhythm and induction of abnormal rhythm,20771.0,10385.5,1635.59,28248.56,32
HCPCS,93622,Insertion of catheters for recording and pacing of left lower heart chamber rhythm and induction of abnormal rhythm,13071.0,6535.5,3921.3,17776.56,32
HCPCS,93623,Programming of heart rhythm stimulation after drug infusion,12074.0,6037.0,3622.2,16420.64,32
HCPCS,93641,Evaluation of single or dual chamber pacing cardioverter-defibrillator and generator at time of implantation or replacement,4052.0,2026.0,1215.6,8475.93,32
HCPCS,93642,Programming of pacing cardioverter-defibrillator,5873.0,2936.5,1567.7,8475.93,32
HCPCS,93644,Programming of implantable defibrillator,3520.0,1760.0,1056.0,8475.93,32
HCPCS,93650,Destruction of heart conduction tissue to create heart block,13052.0,6526.0,3915.6,23251.95,32
HCPCS,93653,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate),48880.0,24440.0,3193.49,66476.8,32
HCPCS,93654,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of lower chamber of heart causing ventricular tachycardia (rapid heart rate) or ventricular ectopy (irregular heart,50250.0,25125.0,15075.0,68340.0,32
HCPCS,93655,Insertion of catheters and destruction of tissue to treat abnormal heart rhythm,25323.0,12661.5,7596.9,34439.28,32
HCPCS,93656,Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation,50250.0,25125.0,3193.49,68340.0,32
HCPCS,93657,Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm,22438.0,11219.0,6731.4,30515.68,32
HCPCS,93660,Evaluation of heart function using tilt table,4117.0,2058.5,208.02,5599.12,32
HCPCS,93662,Ultrasound evaluation of heart blood vessel with review by radiologist,8425.0,4212.5,543.5,11458.0,32
HCPCS,93702,Measurement of lymphedema extracellular fluid,464.0,232.0,77.51,631.04,32
HCPCS,93750,Evaluation of lower heart chamber assist device,403.0,201.5,45.43,548.08,32
HCPCS,93799,Other cardiovascular service or procedure,820.0,410.0,32.27,53181.44,96
HCPCS,93880,Ultrasound of both sides of head and neck blood flow,2298.0,1149.0,180.4,3125.28,32
HCPCS,93882,Ultrasound of one side of head and neck blood flow,963.0,481.5,134.61,1309.68,32
HCPCS,93886,Complete ultrasound of within the brain blood flow,1344.0,672.0,211.36,1827.84,32
HCPCS,93892,Ultrasound of within the brain blood flow for blood clots,1062.0,531.0,134.61,1444.32,32
HCPCS,93896,Ultrasound of blood flow withing brain to assess flexibility of vessels,792.0,396.0,237.6,1077.12,28
HCPCS,93922,Ultrasound study of arm and leg arteries,782.0,391.0,81.53,1063.52,32
HCPCS,93923,Complete ultrasound study of arm and leg arteries,1169.0,584.5,114.87,1589.84,32
HCPCS,93924,Ultrasound of leg arteries at rest and after exercise,1598.0,799.0,137.18,2173.28,32
HCPCS,93925,Ultrasound of leg arteries or artery grafts,1869.0,934.5,162.46,2541.84,32
HCPCS,93926,Ultrasound of one leg arteries or artery grafts,1254.0,627.0,132.5,1705.44,32
HCPCS,93930,Ultrasound of arm arteries or artery grafts,1516.0,758.0,137.18,2061.76,32
HCPCS,93931,Ultrasound of one arm arteries or artery grafts,1077.0,538.5,134.61,1464.72,32
HCPCS,93970,Ultrasound study of arm or leg veins with compression and maneuvers,1850.0,925.0,164.82,2516.0,32
HCPCS,93971,Ultrasound study of one arm or leg veins with compression and maneuvers,1552.0,776.0,122.56,2110.72,32
HCPCS,93975,Complete ultrasound of abdomen and pelvis artery and vein blood flow,2423.0,1211.5,137.99,3295.28,32
HCPCS,93976,Ultrasound of abdomen and pelvis artery and vein blood flow,1334.0,667.0,134.61,1814.24,32
HCPCS,93978,"Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts",1470.0,735.0,211.36,1999.2,32
HCPCS,93979,"Ultrasound of aorta, vena cava, groin vessels or bypass grafts",1059.0,529.5,134.61,1440.24,32
HCPCS,93980,Complete ultrasound of penis artery and vein blood flow,1447.0,723.5,109.76,1967.92,32
HCPCS,93981,Ultrasound of penis artery and vein blood flow,436.0,218.0,94.82,592.96,32
HCPCS,93985,Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access,1185.0,592.5,137.18,1611.6,32
HCPCS,93986,Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access,820.0,410.0,134.61,1115.2,32
HCPCS,93990,Ultrasound of hemodialysis access,1025.0,512.5,134.61,1394.0,32
HCPCS,94002,Initial hospital inpatient or observation ventilation assistance and management,1488.0,744.0,446.4,2023.68,32
HCPCS,94003,Follow-up inpatient or observation ventilation assistance and management,1773.0,886.5,531.9,2411.28,32
HCPCS,94010,Test to measure expiratory airflow and volume,634.0,317.0,46.63,862.24,64
HCPCS,94060,Test to measure expiratory airflow and volume changes before and after medication administration,1083.0,541.5,75.59,1472.88,64
HCPCS,94070,Test to measure lung airway sensitivity,1618.0,809.0,100.95,2200.48,64
HCPCS,94150,Test to measure the total volume of air that can be exhaled after inhaling,342.0,171.0,18.81,465.12,64
HCPCS,94375,Test to measure rate of airflow,551.0,275.5,35.19,749.36,64
HCPCS,94452,Test to measure lung function at high altitude,411.0,205.5,72.29,558.96,64
HCPCS,94453,Test to measure lung function at high altitude with evaluation of oxygen needs at rest and during exercise,510.0,255.0,72.29,693.6,64
HCPCS,94610,Administration of medication through breathing tube,464.0,232.0,72.29,631.04,32
HCPCS,94617,Test for exercise-induced spasm of lung airways,600.0,300.0,72.29,816.0,64
HCPCS,94618,Test for exercise-induced lung stress,650.0,325.0,72.29,884.0,64
HCPCS,94621,Test for exercise-induced heart and lung stress,2375.0,1187.5,129.52,3230.0,64
HCPCS,94625,"Professional services for outpatient pulmonary rehabilitation, per session",272.0,136.0,15.31,369.92,32
HCPCS,94626,"Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session",341.0,170.5,28.32,463.76,32
HCPCS,94640,Inhalation treatment for airway obstruction or sputum production,286.0,143.0,19.27,388.96,160
HCPCS,94642,Inhalation treatment for pneumonia,582.0,291.0,72.29,791.52,64
HCPCS,94644,"Inhalation treatment for acute airway obstruction, first hour",348.0,174.0,72.29,473.28,64
HCPCS,94645,"Inhalation treatment for acute airway obstruction, each additional hour",174.0,87.0,52.2,236.64,32
HCPCS,94660,Therapy procedure using a positive pressure ventilator,892.0,446.0,161.43,1213.12,32
HCPCS,94664,Evaluation of use of breathing device,424.0,212.0,13.7,576.64,64
HCPCS,94667,Initial therapy service to facilitate lung function,297.0,148.5,72.29,403.92,64
HCPCS,94668,Follow-up therapy service to facilitate lung function,222.0,111.0,66.6,301.92,32
HCPCS,94669,Therapy procedure to clear airway using an inflatable vest,318.0,159.0,72.29,432.48,32
HCPCS,94726,Test to determine lung volumes using sensors,939.0,469.5,52.02,1277.04,64
HCPCS,94727,Test to determine lung volumes using gas dilution or washout,666.0,333.0,55.36,905.76,64
HCPCS,94728,Test to measure resistance of the airways and lungs to differing frequencies,506.0,253.0,52.02,688.16,64
HCPCS,94729,Test to examine how well the lungs exchange gases,788.0,394.0,57.93,1071.68,64
HCPCS,94760,Test to measure oxygen level in blood using ear or finger device,109.25,54.63,15.75,148.58,28
HCPCS,94761,Test to measure oxygen level in blood using ear or finger device multiple times,349.0,174.5,26.03,474.64,28
HCPCS,94762,Test to measure oxygen level in blood using ear or finger device continuously overnight,270.0,135.0,21.81,367.2,32
HCPCS,94780,"Test of car seat or bed (1 year or younger), 1 hour",230.0,115.0,48.09,312.8,96
HCPCS,94781,"Test of car seat or bed (1 year or younger), each additional 30 minutes",115.0,57.5,34.5,156.4,64
HCPCS,94799,Other service or procedure on lung,413.5,206.75,22.33,613.36,96
HCPCS,95004,Test for allergy using allergenic extract,90.0,45.0,27.0,1105.7,32
HCPCS,95012,Test to measure the level of nitric oxide gas,313.0,156.5,48.09,425.68,64
HCPCS,95017,Test for allergy using combination of methods with venom,269.0,134.5,37.24,365.84,32
HCPCS,95018,Test for allergy using combination of methods with drug or biological,225.0,112.5,43.71,306.0,32
HCPCS,95024,Test for allergy using allergenic extract injected into skin,239.0,119.5,43.71,325.04,32
HCPCS,95044,Test for allergy using skin patch,120.0,60.0,36.0,1105.7,32
HCPCS,95076,"Test for allergy using ingested items, initial 2 hours",1210.0,605.0,363.0,1645.6,32
HCPCS,95079,"Test for allergy using ingested items, each additional hour",661.0,330.5,198.3,898.96,32
HCPCS,95115,Professional service for single injection of allergen,188.0,94.0,31.46,255.68,32
HCPCS,95117,Professional service for multiple injections of allergen,235.0,117.5,31.46,319.6,32
HCPCS,95148,Professional service for preparation and provision of 4 stinging insect venom,193.0,96.5,31.46,262.48,32
HCPCS,95165,Professional service for preparation and provision of 1 or more antigens,127.0,63.5,31.46,172.72,32
HCPCS,95249,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin,421.0,210.5,75.96,572.56,32
HCPCS,95250,Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment,1027.0,513.5,77.51,1396.72,32
HCPCS,95700,"Measurement of brain wave activity (EEG), continuous",980.0,490.0,278.02,1332.8,32
HCPCS,95711,"Measurement of brain wave activity with video (VEEG), 2-12 hours",2850.0,1425.0,278.02,3876.0,32
HCPCS,95712,"Measurement of brain wave activity with video (VEEG), 2-12 hours with intermittent monitoring",3500.0,1750.0,415.87,4760.0,32
HCPCS,95713,"Measurement of brain wave activity with video (VEEG), 2-12 hours with continuous monitoring",3800.0,1900.0,415.87,5168.0,32
HCPCS,95714,"Measurement of brain wave activity with video (VEEG), 12-26 hours",3375.0,1687.5,480.47,4590.0,32
HCPCS,95716,"Measurement of brain wave activity with video (VEEG), 12-26 hours with continuous monitoring",4206.0,2103.0,562.51,5720.16,32
HCPCS,95782,Sleep study in sleep lab (younger than 6 years),5264.0,2632.0,505.43,7159.04,32
HCPCS,95783,Sleep study in sleep lab with continuous airway pressure (younger than 6 years),5820.0,2910.0,505.43,7915.2,32
HCPCS,95800,"Sleep study including heart rate, breathing, and sleep time",1153.0,576.5,190.54,1568.08,32
HCPCS,95805,"Sleep study, multiple trials",4860.0,2430.0,290.28,6609.6,32
HCPCS,95806,"Sleep study including heart rate, breathing, airflow, and effort",1348.0,674.0,190.54,1833.28,64
HCPCS,95810,Sleep study in sleep lab (6 years or older),6060.0,3030.0,443.39,8241.6,32
HCPCS,95811,Sleep study in sleep lab with continuous airway pressure (6 years or older),7095.0,3547.5,505.43,9649.2,32
HCPCS,95812,"Measurement of brain wave activity (EEG), 41-60 minutes",1892.0,946.0,128.96,2573.12,64
HCPCS,95813,"Measurement of brain wave activity (EEG), 61-119 minutes",2960.0,1480.0,278.02,4025.6,64
HCPCS,95816,"Measurement of brain wave activity (EEG), awake and drowsy",1353.0,676.5,110.63,1840.08,32
HCPCS,95819,"Measurement of brain wave activity (EEG), awake and asleep",1494.0,747.0,102.02,2031.84,32
HCPCS,95822,"Measurement of brain wave activity (EEG), in coma or asleep",1500.0,750.0,278.02,2040.0,32
HCPCS,95829,Measurement of brain wave activity (EEG) during surgery,3525.0,1762.5,415.87,4794.0,32
HCPCS,95860,"Needle measurement of electrical activity in arm or leg muscles, 1 extremity",711.0,355.5,62.91,966.96,32
HCPCS,95861,"Needle measurement of electrical activity in arm or leg muscles, 2 extremities",736.0,368.0,92.03,1000.96,32
HCPCS,95864,"Needle measurement of electrical activity in arm or leg muscles, 4 extremities",850.0,425.0,123.6,1156.0,32
HCPCS,95867,Needle measurement of electrical activity in muscles on side of body,715.0,357.5,166.38,972.4,32
HCPCS,95870,"Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study",319.0,159.5,95.7,433.84,32
HCPCS,95872,"Needle measurement of electrical activity in muscle, including jitter, blocking and/or fiber density",900.0,450.0,166.38,1224.0,32
HCPCS,95874,Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle,367.0,183.5,110.1,530.72,32
HCPCS,95885,"Needle measurement of electrical activity in arm or leg muscles, limited study",594.0,297.0,166.38,807.84,32
HCPCS,95886,"Needle measurement of electrical activity in arm or leg muscles, complete study",669.0,334.5,166.38,909.84,32
HCPCS,95887,Needle measurement of electrical activity in trunk or head muscles,531.0,265.5,159.3,722.16,32
HCPCS,95907,"Nerve conduction, 1-2 studies",685.0,342.5,166.38,931.6,32
HCPCS,95908,"Nerve conduction, 3-4 studies",1233.0,616.5,166.38,1676.88,32
HCPCS,95909,"Nerve conduction, 5-6 studies",1500.0,750.0,166.38,2040.0,32
HCPCS,95910,"Nerve conduction, 7-8 studies",1687.0,843.5,166.38,2294.32,32
HCPCS,95911,"Nerve conduction, 9-10 studies",2446.0,1223.0,166.38,3326.56,32
HCPCS,95912,"Nerve conduction, 11-12 studies",2635.0,1317.5,166.38,3583.6,32
HCPCS,95913,"Nerve conduction, 13 or more studies",2904.0,1452.0,166.38,3949.44,32
HCPCS,95923,Testing of autonomic (sympathetic) nervous system function,576.0,288.0,166.38,783.36,32
HCPCS,95924,"Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt",487.0,243.5,146.1,662.32,32
HCPCS,95925,Placement of skin electrodes and measurement of stimulated sites in arms,1174.0,587.0,66.16,1596.64,64
HCPCS,95926,Placement of skin electrodes and measurement of stimulated sites in legs,1042.0,521.0,118.87,1417.12,32
HCPCS,95928,Placement of skin electrodes and measurement of central motor stimulation in arms,1591.0,795.5,166.38,2163.76,32
HCPCS,95929,Placement of skin electrodes and measurement of central motor stimulation in legs,1105.0,552.5,166.38,1502.8,32
HCPCS,95930,Measurement of nerve conduction using visual stimulation testing with report,1216.0,608.0,52.71,1653.76,32
HCPCS,95933,Measurement of nerve conduction patterns of eye blink reflex,559.0,279.5,75.96,760.24,32
HCPCS,95938,Placement of skin electrodes and measurement of stimulated sites on arms and legs,1216.0,608.0,166.38,1653.76,32
HCPCS,95939,Placement of skin electrodes and measurement of central motor stimulation in arms and legs,2389.0,1194.5,166.38,3249.04,32
HCPCS,95940,"Continuous monitoring of nervous system during operation, each 15 minutes",288.0,144.0,86.4,391.68,56
HCPCS,95941,"Continuous remote monitoring of nervous system during operation, each hour",313.0,156.5,93.9,425.68,28
HCPCS,95955,Measurement of brain wave activity (EEG) outside the brain during surgery,1464.0,732.0,415.87,1991.04,32
HCPCS,95958,Measurement of brain wave activity (EEG) in specific area of brain,2122.0,1061.0,415.87,2885.92,32
HCPCS,95961,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, first hour",1591.0,795.5,415.87,2163.76,64
HCPCS,95962,"Measurement of brain wave activity (EEG) with electrodes on brain to provoke seizures or identify brain structures, each additional hour",501.0,250.5,150.3,681.36,32
HCPCS,95970,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator",683.0,341.5,171.32,928.88,32
HCPCS,95971,Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming,1250.0,625.0,122.41,1700.0,32
HCPCS,95972,Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming,1450.0,725.0,122.41,1972.0,32
HCPCS,95976,Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming,405.0,202.5,48.05,550.8,32
HCPCS,95977,Electronic analysis of implanted neurostimulator generator with complex cranial nerve stimulator programming,625.0,312.5,122.41,850.0,32
HCPCS,95983,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, first 15 minutes with qualified health professional",649.0,324.5,122.41,882.64,32
HCPCS,95984,"Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator with brain stimulator programming, each additional 15 minutes with qualified health professional",448.0,224.0,134.4,609.28,32
HCPCS,95992,"Repositioning exercises of head for treatment of dizziness, each day",295.0,147.5,35.65,401.2,64
HCPCS,96020,Test of neurological function during functional MRI,769.0,384.5,230.7,1045.84,32
HCPCS,96041,"Counseling for genetic testing provided by a genetic counselor, each 30 minutes of total time on the date of encounter",146.0,73.0,43.8,198.56,28
HCPCS,96105,"Test to assess the loss of the ability to speak, write, and understand language",422.0,211.0,96.99,776.84,32
HCPCS,96112,"Administration of developmental test, first hour",507.0,253.5,152.1,776.84,32
HCPCS,96113,"Administration of developmental test, each additional 30 minutes",352.0,176.0,105.6,776.84,32
HCPCS,96116,"Exam of neurobehavioral status, first hour",1003.0,501.5,278.02,1364.08,32
HCPCS,96125,Test to assess the ability to complete specific functional tasks applicable to environment,417.0,208.5,102.65,776.84,32
HCPCS,96127,Assessment of emotional or behavioral problems,155.0,77.5,28.93,210.8,32
HCPCS,96130,"Evaluation of psychological test, first hour",685.0,342.5,205.5,931.6,32
HCPCS,96131,"Evaluation of psychological test, each additional hour",663.0,331.5,198.9,901.68,32
HCPCS,96132,"Evaluation of neuropsychological test, first hour",838.0,419.0,251.4,1139.68,32
HCPCS,96133,"Evaluation of neuropsychological test, each additional hour",569.0,284.5,170.7,776.84,32
HCPCS,96136,"Administration of psychological or neuropsychological test, first 30 minutes",431.0,215.5,129.3,776.84,32
HCPCS,96137,"Administration of psychological or neuropsychological test, each additional 30 minutes",365.0,182.5,109.5,776.84,32
HCPCS,96138,"Administration of psychological or neuropsychological test by technician, first 30 minutes",624.0,312.0,187.2,848.64,32
HCPCS,96139,"Administration of psychological or neuropsychological test by technician, each additional 30 minutes",369.0,184.5,110.7,776.84,32
HCPCS,96156,Assessment of health behavior,285.0,142.5,85.5,387.6,30
HCPCS,96158,"Treatment of behavior impacting health, initial 30 minutes",339.0,169.5,101.7,461.04,30
HCPCS,96159,"Treatment of behavior impacting health, each additional 15 minutes",250.0,125.0,75.0,340.0,26
HCPCS,96160,Administration and interpretation of patient-focused health risk assessment,99.0,49.5,28.93,134.64,24
HCPCS,96167,"Treatment of behavior impacting health with family and patient, initial 30 minutes",156.0,78.0,46.8,224.23,30
HCPCS,96168,"Treatment of behavior impacting health with family and patient, each additional 30 minutes",90.0,45.0,27.0,122.4,26
HCPCS,96360,"Infusion into a vein for hydration, 31-60 minutes",663.0,331.5,198.9,901.68,96
HCPCS,96361,"Infusion into a vein for hydration, each additional hour",445.0,222.5,60.29,613.94,96
HCPCS,96365,"Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less",950.0,475.0,273.88,1292.0,96
HCPCS,96366,"Infusion into a vein for therapy, prevention, or diagnosis, each additional hour",545.0,272.5,60.29,741.2,96
HCPCS,96367,"Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less",678.0,339.0,92.71,922.08,96
HCPCS,96368,"Infusion into a vein for therapy, prevention, or diagnosis concurrent with another infusion",526.0,263.0,157.8,715.36,96
HCPCS,96372,Injection of drug or substance under skin or into muscle,233.0,116.5,58.14,316.88,96
HCPCS,96373,Injection of drug or substance into artery,659.0,329.5,58.14,896.24,32
HCPCS,96374,Injection of drug or substance into vein,528.0,264.0,58.14,718.08,96
HCPCS,96375,Injection of additional new drug or substance into vein,377.0,188.5,58.14,512.72,96
HCPCS,96376,Injection of additional drug or substance into vein provided in a facility,298.0,149.0,58.14,405.28,96
HCPCS,96377,Application of on-body injector for under skin injection,263.0,131.5,58.14,357.68,64
HCPCS,96401,Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle,713.0,356.5,58.14,969.68,64
HCPCS,96402,Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle,580.0,290.0,58.14,788.8,64
HCPCS,96405,"Administration of chemotherapy into growth, 1-7",612.0,306.0,58.14,832.32,32
HCPCS,96409,Administration of chemotherapy into vein using push technique,933.0,466.5,58.14,1268.88,64
HCPCS,96411,Administration of additional new drug or substance into vein using push technique,651.0,325.5,58.14,885.36,64
HCPCS,96413,"Administration of chemotherapy into vein, 1 hour or less",1875.0,937.5,42.23,2550.0,64
HCPCS,96415,"Administration of chemotherapy into vein, each additional hour",843.0,421.5,92.71,1146.48,64
HCPCS,96416,Administration of prolonged chemotherapy into vein,1969.0,984.5,425.3,2677.84,64
HCPCS,96417,"Administration of additional new drug or substance into vein, 1 hour or less",952.0,476.0,92.71,1294.72,64
HCPCS,96450,Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord,1898.0,949.0,425.3,2581.28,64
HCPCS,96521,Refilling and maintenance of portable pump,574.0,287.0,58.14,780.64,32
HCPCS,96523,Irrigation of implanted venous access drug delivery device,374.0,187.0,58.14,508.64,64
HCPCS,96542,Injection of chemotherapy via reservoir under skin,763.0,381.5,58.14,1037.68,32
HCPCS,96567,Application of light to destroy precancer skin growth,563.0,281.5,168.9,765.68,32
HCPCS,96573,Application of light by qualified health care professional to destroy precancer skin growth,623.0,311.5,186.9,847.28,32
HCPCS,96574,Application of light with debridement to destroy precancer skin growth,672.0,336.0,201.6,913.92,32
HCPCS,96900,Application of ultraviolet light to skin,304.0,152.0,38.04,413.44,32
HCPCS,96910,Therapy procedure using ultraviolet radiation with tar or petroleum jelly application,405.0,202.5,45.25,550.8,32
HCPCS,97010,Application of hot or cold packs,71.0,35.5,15.7,96.56,64
HCPCS,97012,Application of mechanical traction,146.0,73.0,14.75,198.56,32
HCPCS,97014,Application of electrical stimulation,101.0,50.5,21.31,137.36,32
HCPCS,97022,Application of whirlpool therapy,115.0,57.5,16.12,156.4,32
HCPCS,97032,"Application of electrical stimulation with therapist present, each 15 minutes",139.0,69.5,14.75,189.04,64
HCPCS,97035,"Application of ultrasound, each 15 minutes",134.0,67.0,14.44,182.24,64
HCPCS,97110,"Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",129.0,64.5,29.54,175.44,64
HCPCS,97112,"Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes",144.0,72.0,31.39,195.84,96
HCPCS,97116,"Therapy procedure for walking training, each 15 minutes",144.0,72.0,26.92,195.84,32
HCPCS,97124,"Therapy procedure using massage, each 15 minutes",125.0,62.5,24.67,170.0,32
HCPCS,97129,"Therapy procedure for a range of mental processes, initial 15 minutes",144.0,72.0,21.9,195.84,64
HCPCS,97130,"Therapy procedure for a range of mental processes, each additional 15 minutes",138.0,69.0,21.25,187.68,64
HCPCS,97140,"Therapy procedure using manual technique, each 15 minutes",178.0,89.0,27.9,242.08,64
HCPCS,97150,Therapy procedure in a group setting,148.0,74.0,18.04,201.28,64
HCPCS,97161,"Evaluation for physical therapy, typically 20 minutes",366.0,183.0,100.75,497.76,32
HCPCS,97162,"Evaluation for physical therapy, typically 30 minutes",443.0,221.5,100.75,602.48,32
HCPCS,97163,"Evaluation for physical therapy, typically 45 minutes",487.0,243.5,100.75,662.32,32
HCPCS,97164,"Re-evaluation for physical therapy, typically 20 minutes",235.0,117.5,69.31,319.6,32
HCPCS,97165,"Evaluation for occupational therapy, typically 30 minutes",366.0,183.0,103.4,497.76,32
HCPCS,97166,"Evaluation for occupational therapy, typically 45 minutes",443.0,221.5,103.4,602.48,32
HCPCS,97167,"Evaluation for occupational therapy, typically 1 hour",487.0,243.5,103.4,662.32,32
HCPCS,97168,"Re-evaluation for occupational therapy, typically 30 minutes",235.0,117.5,70.5,319.6,32
HCPCS,97530,Therapy procedure using functional activities,144.0,72.0,33.64,195.84,96
HCPCS,97535,"Training for self-care or home management, each 15 minutes",144.0,72.0,32.85,195.84,64
HCPCS,97537,"Training for community or work reintegration, each 15 minutes",144.0,72.0,32.5,195.84,32
HCPCS,97542,"Evaluation for wheelchair, each 15 minutes",126.0,63.0,23.56,171.36,64
HCPCS,97550,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community, initial 30 minutes",340.0,170.0,46.11,462.4,20
HCPCS,97551,"Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community, each additional 15 minutes",170.0,85.0,24.53,231.2,20
HCPCS,97552,Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community,170.0,85.0,10.79,231.2,20
HCPCS,97597,"Removal of tissue from wound, 20.0 sq cm or less",623.0,311.5,186.9,847.28,96
HCPCS,97598,"Removal of tissue from wound, each additional 20.0 sq cm",597.0,298.5,25.18,1351.13,64
HCPCS,97602,Removal of tissue from wound gradually,415.0,207.5,124.5,564.4,64
HCPCS,97605,"Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less",558.0,279.0,167.4,758.88,32
HCPCS,97606,"Therapy procedure using a special bandage and vacuum pump, surface area more than 50.0 sq cm",884.0,442.0,265.2,1202.24,32
HCPCS,97607,"Therapy procedure using a special bandage, vacuum pump and disposable medical equipment, surface area 50.0 sq cm or less",1114.0,557.0,334.2,1515.04,32
HCPCS,97750,"Test or measurement for functional capacity, each 15 minutes",161.0,80.5,34.17,218.96,32
HCPCS,97760,"Training in the use of orthopedic device for arm, leg and/or trunk, each 15 minutes",157.0,78.5,32.52,213.52,64
HCPCS,97761,"Training in the use of artificial arm and/or leg, each 15 minutes",156.0,78.0,41.43,212.16,32
HCPCS,97763,"Follow-up training in the use of orthopedic device or artificial arm, leg and/or trunk, each 15 minutes",171.0,85.5,24.67,232.56,32
HCPCS,97802,"Therapy procedure for nutrition management, each 15 minutes",97.0,48.5,29.1,220.89,32
HCPCS,97803,"Therapy procedure reassessment for nutrition management, each 15 minutes",85.0,42.5,25.5,220.89,32
HCPCS,97804,"Therapy procedure for nutrition management with group, each 30 minutes",72.0,36.0,15.41,220.89,32
HCPCS,97810,"Acupuncture, initial 15 minutes",80.0,40.0,24.0,108.8,32
HCPCS,97811,"Acupuncture, each additional 15 minutes",38.0,19.0,11.4,51.68,32
HCPCS,98927,"Osteopathic manipulative treatment, 5-6 body regions",89.0,44.5,26.7,121.04,32
HCPCS,99000,Handling and/or conveyance of specimen for transfer from physician office to laboratory,25.0,12.5,3.43,34.0,32
HCPCS,99002,Handling and/or conveyance of device when created by an outside laboratory or specialty service,48.33,24.17,14.5,65.73,28
HCPCS,99151,"Use of a drug to induce depression of consciousness by physician performing a procedure (younger than 5 years), initial 15 minutes",799.0,399.5,28.57,1086.64,32
HCPCS,99152,"Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,192
HCPCS,99153,"Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,160
HCPCS,99155,"Use of a drug to induce depression of consciousness by physician not performing a procedure (younger than 5 years), initial 15 minutes",799.0,399.5,28.57,1086.64,32
HCPCS,99156,"Use of a drug to induce depression of consciousness by physician not performing a procedure (5 years or older), initial 15 minutes",799.0,399.5,28.57,1086.64,96
HCPCS,99157,"Use of a drug to induce depression of consciousness by physician not performing a procedure, each additional 15 minutes",536.0,268.0,28.57,728.96,64
HCPCS,99184,Treatment by lowering head or total body temperature in neonate,1800.0,900.0,540.0,2448.0,28
HCPCS,99195,Drawing of blood for a medical problem,461.0,230.5,94.28,626.96,32
HCPCS,99202,"New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more",180.0,90.0,73.26,244.8,20
HCPCS,99203,"New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more",214.0,107.0,87.1,291.04,20
HCPCS,99204,"New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more",250.0,125.0,88.0,340.0,20
HCPCS,99205,"New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more",275.0,137.5,88.0,374.0,20
HCPCS,99211,Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional,149.0,74.5,60.64,202.64,40
HCPCS,99212,"Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more",164.0,82.0,66.75,223.04,40
HCPCS,99213,"Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more",185.0,92.5,75.3,251.6,40
HCPCS,99214,"Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more",215.0,107.5,87.51,292.4,40
HCPCS,99215,"Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more",263.0,131.5,88.0,357.68,40
HCPCS,99281,Emergency department visit for problem that may not require health care professional,515.0,257.5,108.57,700.4,28
HCPCS,99282,Emergency department visit with straightforward medical decision making,1003.0,501.5,197.7,1364.08,28
HCPCS,99283,Emergency department visit with low level of medical decision making,2349.0,1174.5,351.48,3194.64,28
HCPCS,99284,Emergency department visit with moderate level of medical decision making,3495.0,1747.5,537.27,4753.2,28
HCPCS,99285,Emergency department visit with high level of medical decision making,4297.0,2148.5,766.8,5843.92,28
HCPCS,99291,"Critical care, first 30-74 minutes",4974.0,2487.0,1063.6,6764.64,56
HCPCS,99292,"Critical care, each additional 30 minutes",1071.0,535.5,321.3,1456.56,56
HCPCS,99366,"Medical team conference with patient and/or family, and nonphysician health care professionals, 30 minutes or more",85.0,42.5,25.5,144.65,32
HCPCS,99367,"Medical team conference with physician, 30 minutes or more",85.0,42.5,25.5,144.65,32
HCPCS,99385,Initial new patient preventive medicine evaluation (18-39 years),161.0,80.5,65.53,218.96,20
HCPCS,99386,Initial new patient preventive medicine evaluation (40-64 years),215.0,107.5,87.51,292.4,20
HCPCS,99387,Initial new patient preventive medicine evaluation (65 years or older),221.0,110.5,88.0,300.56,20
HCPCS,99395,Established patient periodic preventive medicine examination (18-39 years),163.0,81.5,66.34,221.68,20
HCPCS,99396,Established patient periodic preventive medicine examination (40-64 years),177.0,88.5,72.04,240.72,20
HCPCS,99397,Established patient periodic preventive medicine examination (65 year old or older),199.0,99.5,80.99,270.64,20
HCPCS,99406,"Smoking and tobacco use intermediate counseling, 3-10 minutes",87.0,43.5,26.1,118.32,32
HCPCS,99407,"Smoking and tobacco use intensive counseling, more than 10 minutes",100.0,50.0,28.93,136.0,32
HCPCS,99415,"Extended office or other outpatient service by clinical staff, first hour",79.0,39.5,32.15,107.44,20
HCPCS,99464,Physician attendance at delivery and stabilization of newborn,525.0,262.5,157.5,714.0,28
HCPCS,99465,Reviving newborn at delivery,1650.0,825.0,495.0,2244.0,32
HCPCS,99495,Transitional care management services for problem of at least moderate complexity,241.0,120.5,88.0,327.76,24
HCPCS,99496,Transitional care management services for problem of high complexity,286.0,143.0,88.0,388.96,24
HCPCS,A2006,"NOVOSORB SYNPATH DERMAL MATRIX, PER SQUARE CENTIMETER",45.59,22.79,13.68,160.23,28
HCPCS,A2007,"RESTRATA, PER SQUARE CENTIMETER",344.78,172.39,103.43,468.9,28
HCPCS,A2026,"RESTRATA MINIMATRIX, 5 MG",84.41,42.2,25.32,114.8,28
HCPCS,A2027,"MATRIDERM, PER SQUARE CENTIMETER",314.07,157.04,94.22,427.14,28
HCPCS,A4216,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",2.93,1.47,0.54,1.94,28
HCPCS,A4262,"TEMPORARY, ABSORBABLE LACRIMAL DUCT IMPLANT, EACH",413.66,206.83,124.1,562.57,28
HCPCS,A4263,"PERMANENT, LONG TERM, NON-DISSOLVABLE LACRIMAL DUCT IMPLANT, EACH",281.77,140.885,38.4,592.33,56
HCPCS,A4301,"IMPLANTABLE ACCESS TOTAL CATHETER, PORT/RESERVOIR (E.G., VENOUS, ARTERIAL, EPIDURAL, SUBARACHNOID, PERITONEAL, ETC.)",1692.21,846.11,507.66,2301.41,28
HCPCS,A4338,"INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH",11.0,5.5,3.3,23.77,28
HCPCS,A4351,"INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMER, ETC.), EACH",10.0,5.0,2.58,6.6,28
HCPCS,A4561,"PESSARY, REUSABLE, RUBBER, ANY TYPE",127.0,63.5,29.21,83.82,28
HCPCS,A4565,SLINGS,14.934999999999999,7.470000000000001,4.16,14.93,56
HCPCS,A4648,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",241.0,120.5,34.2,9905.48,504
HCPCS,A7520,"TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",142.0,71.0,37.5,236.94,140
HCPCS,A7521,"TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR EQUAL, EACH",588.0,294.0,67.04,388.08,28
HCPCS,A9500,"TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDY DOSE",562.0,281.0,168.6,764.32,28
HCPCS,A9502,"TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE",733.0,366.5,192.89,996.88,28
HCPCS,A9503,"TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",184.0,92.0,55.2,250.24,28
HCPCS,A9508,"IODINE I-131 IOBENGUANE SULFATE, DIAGNOSTIC, PER 0.5 MILLICURIE",14228.0,7114.0,1572.47,19350.08,27
HCPCS,A9509,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER MILLICURIE",1226.0,613.0,287.13,1667.36,28
HCPCS,A9512,"TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE",102.0,51.0,19.83,138.72,28
HCPCS,A9513,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",712.5,356.25,213.75,47865.64,31
HCPCS,A9516,"IODINE I-123 SODIUM IODIDE, DIAGNOSTIC, PER 100 MICROCURIES, UP TO 999 MICROCURIES",863.0,431.5,199.5,1173.68,28
HCPCS,A9517,"IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE",135.0,67.5,39.72,531.39,31
HCPCS,A9520,"TECHNETIUM TC-99M TILMANOCEPT, DIAGNOSTIC, UP TO 0.5 MILLICURIES",1541.0,770.5,462.3,2095.76,52
HCPCS,A9521,"TECHNETIUM TC-99M EXAMETAZIME, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",3109.0,1554.5,932.7,4228.24,27
HCPCS,A9524,"IODINE I-131 IODINATED SERUM ALBUMIN, DIAGNOSTIC, PER 5 MICROCURIES",3736.0,1868.0,1120.8,5080.96,28
HCPCS,A9537,"TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",339.0,169.5,101.7,461.04,28
HCPCS,A9538,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",101.0,50.5,30.3,137.36,28
HCPCS,A9539,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES",84.0,42.0,25.2,114.24,28
HCPCS,A9540,"TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",372.0,186.0,50.14,505.92,28
HCPCS,A9541,"TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES",258.0,129.0,77.4,1239.81,56
HCPCS,A9547,"INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE",2241.0,1120.5,672.3,3047.76,27
HCPCS,A9550,"TECHNETIUM TC-99M SODIUM GLUCEPTATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIE",161.0,80.5,48.3,218.96,26
HCPCS,A9551,"TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES",495.0,247.5,148.5,1088.88,27
HCPCS,A9552,"FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES",542.0,271.0,162.6,737.12,56
HCPCS,A9555,"RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURIES",300.0,150.0,90.0,882.88,28
HCPCS,A9556,"GALLIUM GA-67 CITRATE, DIAGNOSTIC, PER MILLICURIE",186.0,93.0,37.47,252.96,28
HCPCS,A9558,"XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES",253.0,126.5,75.9,505.38,28
HCPCS,A9560,"TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",230.0,115.0,69.0,312.8,28
HCPCS,A9561,"TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES",137.0,68.5,41.1,186.32,28
HCPCS,A9562,"TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",1217.0,608.5,365.1,1655.12,28
HCPCS,A9567,"TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES",430.0,215.0,34.72,584.8,28
HCPCS,A9570,"INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE",4837.0,2418.5,1451.1,6578.32,27
HCPCS,A9573,"INJECTION, GADOPICLENOL, 1 ML",17.78,8.895,3.6,42.62,56
HCPCS,A9579,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",7.84,3.92,2.33,22.56,28
HCPCS,A9581,"INJECTION, GADOXETATE DISODIUM, 1 ML",48.83,24.41,14.65,66.41,56
HCPCS,A9582,"IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES",10191.0,5095.5,3057.3,13859.76,27
HCPCS,A9584,"IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES",1988.0,994.0,596.4,2703.68,27
HCPCS,A9587,"GALLIUM GA-68, DOTATATE, DIAGNOSTIC, 0.1 MILLICURIE",219.0,109.5,65.7,297.84,27
HCPCS,A9588,"FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURIE",1352.0,676.0,405.6,1838.72,27
HCPCS,A9589,"INSTILLATION, HEXAMINOLEVULINATE HYDROCHLORIDE, 100 MG",3246.0,1623.0,973.8,4414.56,28
HCPCS,A9591,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MILLICURIE",2053.0,1026.5,615.9,2792.08,27
HCPCS,A9595,"PIFLUFOLASTAT F 18 (PYLARIFY), DIAGNOSTIC, 1 MILLICURIE",1845.0,922.5,553.5,2509.2,27
HCPCS,A9596,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (ILLUCCIX), 1 MILLICURIE",3695.0,1847.5,789.56,5025.2,27
HCPCS,A9606,"RADIUM RA-223 DICHLORIDE, THERAPEUTIC, PER MICROCURIE",560.0,280.0,168.0,16409.66,31
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC, 1 MILLICURIE",690.0,345.0,207.0,47865.64,31
HCPCS,A9800,"GALLIUM GA-68 GOZETOTIDE, DIAGNOSTIC, (LOCAMETZ), 1 MILLICURIE",2123.0,1061.5,598.13,2887.28,27
HCPCS,C1052,"HEMOSTATIC AGENT, GASTROINTESTINAL, TOPICAL",3301.4849999999997,1650.74,904.5,4879.63,28
HCPCS,C1600,"CATHETER, TRANSLUMINAL INTRAVASCULAR LESION PREPARATION DEVICE, BLADED, SHEATHED (INSERTABLE)",8019.9,4009.95,2405.97,10907.06,27
HCPCS,C1601,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), PULMONARY, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",4860.0,2430.0,1458.0,6609.6,27
HCPCS,C1602,"ORTHOPEDIC/DEVICE/DRUG MATRIX/ABSORBABLE BONE VOID FILLER, ANTIMICROBIAL-ELUTING (IMPLANTABLE)",24584.03,12292.01,2704.24,33434.27,27
HCPCS,C1603,"RETRIEVAL DEVICE, INSERTABLE, LASER (USED TO RETRIEVE INTRAVASCULAR INFERIOR VENA CAVA FILTER)",12274.55,6137.28,3682.37,16693.39,27
HCPCS,C1605,"PACEMAKER, LEADLESS, DUAL CHAMBER (RIGHT ATRIAL AND RIGHT VENTRICULAR IMPLANTABLE COMPONENTS), RATE-RESPONSIVE, INCLUDING ALL NECESSARY COMPONENTS FOR IMPLANTATION",99296.0,49648.0,10922.56,135042.56,27
HCPCS,C1713,ANCHOR/SCREW FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO-BONE (IMPLANTABLE),1398.43,699.21,0.46,177289.1,6580
HCPCS,C1714,"CATHETER, TRANSLUMINAL ATHERECTOMY, DIRECTIONAL",12369.8,6184.9,3710.94,16822.93,28
HCPCS,C1715,BRACHYTHERAPY NEEDLE,68.0,34.0,20.4,92.48,28
HCPCS,C1717,"BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE",405.0,202.5,121.5,550.8,32
HCPCS,C1721,"CARDIOVERTER-DEFIBRILLATOR, DUAL CHAMBER (IMPLANTABLE)",42165.5,21082.75,4638.21,57345.08,28
HCPCS,C1722,"CARDIOVERTER-DEFIBRILLATOR, SINGLE CHAMBER (IMPLANTABLE)",37554.1,18777.05,4130.95,51073.58,28
HCPCS,C1724,"CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL",10619.86,5309.93,2428.57,17876.52,28
HCPCS,C1725,"CATHETER, TRANSLUMINAL ANGIOPLASTY, NON-LASER (MAY INCLUDE GUIDANCE, INFUSION/PERFUSION CAPABILITY)",932.24,466.12,193.47,3961.53,112
HCPCS,C1726,"CATHETER, BALLOON DILATATION, NON-VASCULAR",1707.61,853.8,123.21,6894.1,140
HCPCS,C1727,"CATHETER, BALLOON TISSUE DISSECTOR, NON-VASCULAR (INSERTABLE)",805.05,402.53,241.52,1094.87,28
HCPCS,C1728,"CATHETER, BRACHYTHERAPY SEED ADMINISTRATION",432.0,216.0,129.6,587.52,28
HCPCS,C1729,"CATHETER, DRAINAGE",511.33,255.67,23.57,2794.98,224
HCPCS,C1730,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)",2630.54,1315.2749999999999,335.05,4643.1,28
HCPCS,C1731,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (20 OR MORE ELECTRODES)",4081.31,2040.65,1224.39,5550.57,28
HCPCS,C1732,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, 3D OR VECTOR MAPPING",9245.72,4622.86,2773.72,12574.18,28
HCPCS,C1733,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, OTHER THAN COOL-TIP",14923.77,7461.89,149.11,28677.39,28
HCPCS,C1734,ORTHOPEDIC/DEVICE/DRUG MATRIX FOR OPPOSING BONE-TO-BONE OR SOFT TISSUE-TO BONE (IMPLANTABLE),12466.32,6233.16,1371.3,16954.2,28
HCPCS,C1747,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), URINARY TRACT, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",10742.76,5371.38,3222.83,14610.16,28
HCPCS,C1748,"ENDOSCOPE, SINGLE-USE (I.E. DISPOSABLE), UPPER GI, IMAGING/ILLUMINATION DEVICE (INSERTABLE)",10478.0,5239.0,3143.4,14250.08,28
HCPCS,C1750,"CATHETER, HEMODIALYSIS/PERITONEAL, LONG-TERM",2412.0,1206.0,308.53,4801.64,56
HCPCS,C1751,"CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)",597.8,298.9,42.64,4911.98,140
HCPCS,C1752,"CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM",725.0,362.5,203.84,1462.82,28
HCPCS,C1753,"CATHETER, INTRAVASCULAR ULTRASOUND",3745.9300000000003,1872.9650000000001,1206.0,5467.2,28
HCPCS,C1755,"CATHETER, INTRASPINAL",2052.125,1026.065,272.09,4348.33,28
HCPCS,C1757,"CATHETER, THROMBECTOMY/EMBOLECTOMY",3495.86,1747.93,104.53,20296.78,56
HCPCS,C1758,"CATHETER, URETERAL",66.385,33.195,16.47,120.82,56
HCPCS,C1759,"CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY",6132.505,3066.25,231.22,17417.45,28
HCPCS,C1760,"CLOSURE DEVICE, VASCULAR (IMPLANTABLE/INSERTABLE)",947.09,473.54,284.13,1344.8,28
HCPCS,C1761,"CATHETER, TRANSLUMINAL INTRAVASCULAR LITHOTRIPSY, CORONARY",17907.0,8953.5,5372.1,24353.52,28
HCPCS,C1762,"CONNECTIVE TISSUE, HUMAN (INCLUDES FASCIA LATA)",3128.795,1564.3999999999999,212.65,14396.41,112
HCPCS,C1763,"CONNECTIVE TISSUE, NON-HUMAN (INCLUDES SYNTHETIC)",501.61,250.805,20.98,1284.74,28
HCPCS,C1764,"EVENT RECORDER, CARDIAC (IMPLANTABLE)",15948.6,7974.3,1739.27,21715.7,28
HCPCS,C1765,ADHESION BARRIER,1592.86,796.43,477.86,2166.28,28
HCPCS,C1766,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY",3474.8,1737.4,746.11,6179.66,28
HCPCS,C1767,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), NON-RECHARGEABLE",94168.09,47084.04,10358.49,128068.6,28
HCPCS,C1768,"GRAFT, VASCULAR",491.04999999999995,245.52499999999998,19.38,8747.52,616
HCPCS,C1769,GUIDE WIRE,403.15,201.58,15.99,13893.15,420
HCPCS,C1771,"REPAIR DEVICE, URINARY, INCONTINENCE, WITH SLING GRAFT",5409.855,2704.9300000000003,1557.51,7654.08,56
HCPCS,C1772,"INFUSION PUMP, PROGRAMMABLE (IMPLANTABLE)",43135.89,21567.95,4744.95,58664.81,28
HCPCS,C1773,"RETRIEVAL DEVICE, INSERTABLE (USED TO RETRIEVE FRACTURED MEDICAL DEVICES)",1464.34,732.17,352.2,11517.55,56
HCPCS,C1776,JOINT DEVICE (IMPLANTABLE),2158.74,1061.92,4.76,98192.0,4732
HCPCS,C1777,"LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)",10545.39,5272.69,1159.99,14341.73,28
HCPCS,C1778,"LEAD, NEUROSTIMULATOR (IMPLANTABLE)",5414.94,2707.47,41.4,22310.91,168
HCPCS,C1781,MESH (IMPLANTABLE),3999.9,1999.95,257.24,18800.98,112
HCPCS,C1783,"OCULAR IMPLANT, AQUEOUS DRAINAGE ASSIST DEVICE",6358.85,3179.42,1907.65,8648.03,28
HCPCS,C1784,"OCULAR DEVICE, INTRAOPERATIVE, DETACHED RETINA",195.55,97.77,58.66,265.94,28
HCPCS,C1785,"PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",12513.95,6256.97,1376.53,17018.97,28
HCPCS,C1786,"PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)",39257.21,19628.6,4318.29,53389.8,28
HCPCS,C1787,"PATIENT PROGRAMMER, NEUROSTIMULATOR",1973.985,986.995,182.4,4542.36,56
HCPCS,C1788,"PORT, INDWELLING (IMPLANTABLE)",1648.18,824.09,369.25,3827.04,56
HCPCS,C1789,"PROSTHESIS, BREAST (IMPLANTABLE)",3187.62,1593.81,140.91,108011.2,420
HCPCS,C1813,"PROSTHESIS, PENILE, INFLATABLE",37276.03,18638.01,4100.36,50695.4,28
HCPCS,C1814,"RETINAL TAMPONADE DEVICE, SILICONE OIL",1633.62,816.81,490.09,2221.72,28
HCPCS,C1815,"PROSTHESIS, URINARY SPHINCTER (IMPLANTABLE)",40686.43,20343.215,3093.79,72416.6,56
HCPCS,C1817,"SEPTAL DEFECT IMPLANT SYSTEM, INTRACARDIAC",28653.56,14326.785,3761.94,46511.28,28
HCPCS,C1819,SURGICAL TISSUE LOCALIZATION AND EXCISION DEVICE (IMPLANTABLE),117.19,58.59,35.16,159.37,28
HCPCS,C1820,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), WITH RECHARGEABLE BATTERY AND CHARGING SYSTEM",80045.45,40022.72,8805.0,108861.81,28
HCPCS,C1821,INTERSPINOUS PROCESS DISTRACTION DEVICE (IMPLANTABLE),4482.05,2241.025,62.84,15980.95,224
HCPCS,C1827,"GENERATOR, NEUROSTIMULATOR (IMPLANTABLE), NON-RECHARGEABLE, WITH IMPLANTABLE STIMULATION LEAD AND EXTERNAL PAIRED STIMULATION CONTROLLER",106495.0,53247.5,11714.45,144833.2,28
HCPCS,C1830,POWERED BONE MARROW BIOPSY NEEDLE,4018.16,2009.08,320.42,9567.6,28
HCPCS,C1831,"INTERBODY CAGE, ANTERIOR, LATERAL OR POSTERIOR, PERSONALIZED (IMPLANTABLE)",5025.0,2512.5,230.58,95148.05,448
HCPCS,C1833,"MONITOR, CARDIAC, INCLUDING INTRACARDIAC LEAD AND ALL SYSTEM COMPONENTS (IMPLANTABLE)",6030.0,3015.0,1809.0,8200.8,28
HCPCS,C1874,"STENT, COATED/COVERED, WITH DELIVERY SYSTEM",6094.84,3047.42,12.0,134523.04,364
HCPCS,C1876,"STENT, NON-COATED/NON-COVERED, WITH DELIVERY SYSTEM",2412.0,1206.0,238.91,22589.94,252
HCPCS,C1880,VENA CAVA FILTER,3854.7250000000004,1927.365,1131.24,5677.11,28
HCPCS,C1882,"CARDIOVERTER-DEFIBRILLATOR, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",51548.33,25774.16,5670.32,70105.72,28
HCPCS,C1883,"ADAPTER/EXTENSION, PACING LEAD OR NEUROSTIMULATOR LEAD (IMPLANTABLE)",2554.18,1277.09,766.25,3473.68,28
HCPCS,C1884,EMBOLIZATION PROTECTIVE SYSTEM,9800.21,4900.1050000000005,1327.65,20726.4,28
HCPCS,C1885,"CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER",11201.4,5600.7,3086.1,15233.9,28
HCPCS,C1886,"CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE)",5392.0,2696.0,1341.0,10739.07,84
HCPCS,C1887,"CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)",540.105,270.05,56.42,4345.34,140
HCPCS,C1888,"CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)",7392.78,3696.39,1070.03,20985.48,28
HCPCS,C1889,"IMPLANTABLE/INSERTABLE DEVICE, NOT OTHERWISE CLASSIFIED",3566.73,1783.3600000000001,6.19,211112.8,1736
HCPCS,C1892,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, PEEL-AWAY",576.45,288.23,63.09,1066.43,56
HCPCS,C1893,"INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY",797.83,398.91,239.35,1085.05,28
HCPCS,C1894,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, NON-LASER",768.6,384.3,45.89,529839.12,504
HCPCS,C1896,"LEAD, CARDIOVERTER-DEFIBRILLATOR, OTHER THAN ENDOCARDIAL SINGLE OR DUAL COIL (IMPLANTABLE)",15601.95,7800.98,1716.21,21218.65,28
HCPCS,C1897,"LEAD, NEUROSTIMULATOR TEST KIT (IMPLANTABLE)",3154.2,1577.1,82.2,8206.78,56
HCPCS,C1898,"LEAD, PACEMAKER, OTHER THAN TRANSVENOUS VDD SINGLE PASS",1641.63,820.815,491.05,2239.14,28
HCPCS,C1899,"LEAD, PACEMAKER/CARDIOVERTER-DEFIBRILLATOR COMBINATION (IMPLANTABLE)",1921.5,960.75,576.45,2613.24,28
HCPCS,C1900,"LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM",6290.55,3145.28,1887.17,8555.15,28
HCPCS,C2596,"PROBE, IMAGE-GUIDED, ROBOTIC, WATERJET ABLATION",12573.0,6286.5,3771.9,17099.28,28
HCPCS,C2616,"BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE",33595.235,16797.62,658.48,88393.95,64
HCPCS,C2617,"STENT, NON-CORONARY, TEMPORARY, WITHOUT DELIVERY SYSTEM",763.265,381.63,20.46,14814.09,448
HCPCS,C2618,"PROBE/NEEDLE, CRYOABLATION",3863.0,1931.5,403.52,10482.89,84
HCPCS,C2620,"PACEMAKER, SINGLE CHAMBER, NON RATE-RESPONSIVE (IMPLANTABLE)",555.1,277.55,166.53,754.94,56
HCPCS,C2621,"PACEMAKER, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)",22399.84,11199.92,2463.98,30463.78,28
HCPCS,C2622,"PROSTHESIS, PENILE, NON-INFLATABLE",41555.27,20777.63,4571.08,56515.16,28
HCPCS,C2623,"CATHETER, TRANSLUMINAL ANGIOPLASTY, DRUG-COATED, NON-LASER",5822.18,2911.09,238.27,8232.24,56
HCPCS,C2624,"IMPLANTABLE WIRELESS PULMONARY ARTERY PRESSURE SENSOR WITH DELIVERY CATHETER, INCLUDING ALL SYSTEM COMPONENTS",63175.0,31587.5,6949.25,85918.0,28
HCPCS,C2625,"STENT, NON-CORONARY, TEMPORARY, WITH DELIVERY SYSTEM",938.84,469.42,119.75,5729.63,168
HCPCS,C2627,"CATHETER, SUPRAPUBIC/CYSTOSCOPIC",79.38,39.69,2.5,527.68,84
HCPCS,C2628,"CATHETER, OCCLUSION",2268.52,1134.26,1.31,9987.36,140
HCPCS,C2629,"INTRODUCER/SHEATH, OTHER THAN GUIDING, OTHER THAN INTRACARDIAC ELECTROPHYSIOLOGICAL, LASER",12351.625,6175.8150000000005,3667.65,16626.68,28
HCPCS,C2630,"CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP",29747.7,14873.85,4071.76,63608.78,28
HCPCS,C2631,"REPAIR DEVICE, URINARY, INCONTINENCE, WITHOUT SLING GRAFT",3159.08,1579.54,947.72,4296.35,28
HCPCS,C2642,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",94117.86,47058.93,150.12,128000.29,32
HCPCS,C8000,"SUPPORT DEVICE, EXTRAVASCULAR, FOR ARTERIOVENOUS FISTULA (IMPLANTABLE)",18669.0,9334.5,2053.59,25389.84,27
HCPCS,C8921,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE",3088.0,1544.0,543.5,4199.68,32
HCPCS,C8922,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY",2194.0,1097.0,543.5,2983.84,32
HCPCS,C8924,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED ST",2075.0,1037.5,449.2,2822.0,32
HCPCS,C8925,"TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEME",3545.0,1772.5,543.5,4821.2,32
HCPCS,C8928,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOV",4513.0,2256.5,543.5,6137.68,32
HCPCS,C8929,"TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL",4934.0,2467.0,543.5,6710.24,32
HCPCS,C8930,"TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIO",4316.0,2158.0,543.5,5869.76,32
HCPCS,C9046,"COCAINE HYDROCHLORIDE NASAL SOLUTION (GOPRELTO), 1 MG",3.28,1.64,0.98,4.45,26
HCPCS,C9293,"INJECTION, GLUCARPIDASE, 10 UNITS",1065.77,532.88,319.73,20978.86,31
HCPCS,C9399,UNCLASSIFIED DRUGS OR BIOLOGICALS,1104.35,552.18,0.5,1501.92,28
HCPCS,C9460,"INJECTION, CANGRELOR, 1 MG",41.2,20.6,12.36,604.48,31
HCPCS,C9600,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",22268.28,11134.14,2630.27,32519.72,64
HCPCS,C9601,"PERCUTANEOUS TRANSCATHETER PLACEMENT OF DRUG-ELUTING INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO",18497.0,9248.5,5549.1,25155.92,32
HCPCS,C9602,"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH DRUG ELUTING INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH",28359.0,14179.5,8507.7,38568.24,32
HCPCS,C9604,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",29329.0,14664.5,8798.7,39887.44,32
HCPCS,C9605,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND A",18142.0,9071.0,5442.6,24673.12,32
HCPCS,C9606,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRA",19250.0,9625.0,5775.0,26180.0,32
HCPCS,C9607,"PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, A",28078.0,14039.0,8423.4,38186.08,32
HCPCS,C9610,"CATHETER, TRANSLUMINAL DRUG DELIVERY WITH OR WITHOUT ANGIOPLASTY, CORONARY, NON-LASER (INSERTABLE)",21526.5,10763.25,2367.92,29276.04,27
HCPCS,C9764,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL(S), WHEN PERFORM",17732.0,8866.0,4624.13,24115.52,32
HCPCS,C9765,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, LOWER EXTREMITY ARTERY(IES), EXCEPT TIBIAL/PERONEAL; WITH INTRAVASCULAR LITHOTRIPSY, AND TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WI",28078.0,14039.0,7754.24,38186.08,32
HCPCS,C9772,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL/PERONEAL ARTERY(IES), WITH INTRAVASCULAR LITHOTRIPSY, INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL (S), WHEN PERFORMED",23100.0,11550.0,6930.0,31416.0,32
HCPCS,C9779,"ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD), INCLUDING ENDOSCOPY OR COLONOSCOPY, MUCOSAL CLOSURE, WHEN PERFORMED",10114.0,5057.0,2516.76,13755.04,32
HCPCS,C9785,"ENDOSCOPIC OUTLET REDUCTION, GASTRIC POUCH APPLICATION, WITH ENDOSCOPY AND INTRALUMINAL TUBE INSERTION, IF PERFORMED, INCLUDING ALL SYSTEM AND TISSUE ANCHORING COMPONENTS",30523.0,15261.5,4447.47,41511.28,32
HCPCS,C9901,"ENDOSCOPIC DEFECT CLOSURE WITHIN THE ENTIRE GASTROINTESTINAL TRACT, INCLUDING UPPER ENDOSCOPY (INCLUDING DIAGNOSTIC, IF PERFORMED) OR COLONOSCOPY (INCLUDING DIAGNOSTIC, IF PERFORMED), WITH ALL SYSTEM ",16280.0,8140.0,4884.0,22140.8,28
HCPCS,G0101,CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION,160.0,80.0,48.0,217.6,28
HCPCS,G0103,PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA),168.0,84.0,11.72,228.48,32
HCPCS,G0104,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,2530.0,1265.0,759.0,3440.8,32
HCPCS,G0105,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK,4050.0,2025.0,1197.41,5508.0,32
HCPCS,G0108,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, INDIVIDUAL, PER 30 MINUTES",187.0,93.5,55.09,254.32,32
HCPCS,G0109,"DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION (2 OR MORE), PER 30 MINUTES",124.0,62.0,15.74,168.64,32
HCPCS,G0121,COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK,4034.0,2017.0,1197.41,5486.24,32
HCPCS,G0176,"ACTIVITY THERAPY, SUCH AS MUSIC, DANCE, ART OR PLAY THERAPIES NOT FOR RECREATION, RELATED TO THE CARE AND TREATMENT OF PATIENT'S DISABLING MENTAL HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE)",470.0,235.0,141.0,639.2,30
HCPCS,G0268,REMOVAL OF IMPACTED CERUMEN (ONE OR BOTH EARS) BY PHYSICIAN ON SAME DATE OF SERVICE AS AUDIOLOGIC FUNCTION TESTING,190.0,95.0,57.0,258.4,28
HCPCS,G0278,"ILIAC AND/OR FEMORAL ARTERY ANGIOGRAPHY, NON-SELECTIVE, BILATERAL OR IPSILATERAL TO CATHETER INSERTION, PERFORMED AT THE SAME TIME AS CARDIAC CATHETERIZATION AND/OR CORONARY ANGIOGRAPHY, INCLUDES POSI",3130.0,1565.0,939.0,5880.39,32
HCPCS,G0378,"HOSPITAL OBSERVATION SERVICE, PER HOUR",140.0,70.0,42.0,931.04,32
HCPCS,G0379,DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE,1905.0,952.5,571.5,2590.8,28
HCPCS,G0416,"SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATIONS, FOR PROSTATE NEEDLE BIOPSY, ANY METHOD",2667.0,1333.5,165.12,3627.12,32
HCPCS,J0129,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",146.88,73.44,41.4,2382.19,62
HCPCS,J0132,"INJECTION, ACETYLCYSTEINE, 100 MG",6.029999999999999,3.0149999999999997,0.61,12.61,28
HCPCS,J0133,"INJECTION, ACYCLOVIR, 5 MG",2.43,1.21,0.2,8.22,84
HCPCS,J0134,"INJECTION, ACETAMINOPHEN (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0131, 10 MG",24.87,12.435,0.1,65.27,56
HCPCS,J0153,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",7.82,3.91,0.53,40.8,84
HCPCS,J0165,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",217.0,108.5,0.71,314.55,112
HCPCS,J0166,"INJECTION, EPINEPHRINE (BPI), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",123.28999999999999,61.644999999999996,1.08,316.88,84
HCPCS,J0167,"INJECTION, EPINEPHRINE (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",6.13,3.06,0.91,9.01,28
HCPCS,J0169,"INJECTION, EPINEPHRINE (ADRENALIN), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",15.695,7.85,2.28,23.38,28
HCPCS,J0174,"INJECTION, LECANEMAB-IRMB, 1 MG",4.75,2.38,1.43,736.42,31
HCPCS,J0175,"INJECTION, DONANEMAB-AZBT, 2 MG",14.74,7.37,4.42,20.05,27
HCPCS,J0180,"INJECTION, AGALSIDASE BETA, 1 MG",502.64,251.32,150.79,9401.8,62
HCPCS,J0219,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",65.17,32.59,19.55,28568.47,31
HCPCS,J0223,"INJECTION, GIVOSIRAN, 0.5 MG",289.265,144.63,67.16,28568.47,31
HCPCS,J0248,"INJECTION, REMDESIVIR, 1 MG",14.07,7.035,4.21,604.48,31
HCPCS,J0270,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",2.17,1.09,0.65,2.96,28
HCPCS,J0278,"INJECTION, AMIKACIN SULFATE, 100 MG",34.335,17.17,1.02,316.88,28
HCPCS,J0280,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",35.755,17.88,4.59,76.45,56
HCPCS,J0281,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",19.0,9.5,2.62,25.84,28
HCPCS,J0282,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.375,1.685,0.68,4.61,56
HCPCS,J0283,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",31.9,15.95,2.52,43.38,28
HCPCS,J0285,"INJECTION, AMPHOTERICIN B, 50 MG",150.25,75.13,45.08,204.34,28
HCPCS,J0289,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",101.11500000000001,50.555,15.42,736.42,31
HCPCS,J0290,"INJECTION, AMPICILLIN SODIUM, 500 MG",28.9,14.45,0.97,78.69,196
HCPCS,J0295,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",56.41,28.21,2.19,81.65,140
HCPCS,J0330,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",19.35,9.675,2.56,31.8,28
HCPCS,J0360,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",63.89,31.94,7.24,404.26,84
HCPCS,J0456,"INJECTION, AZITHROMYCIN, 500 MG",60.15,30.08,3.37,226.6,28
HCPCS,J0457,"INJECTION, AZTREONAM, 100 MG",12.0,6.0,3.06,18.77,56
HCPCS,J0461,"INJECTION, ATROPINE SULFATE, 0.01 MG",3.91,4.915,0.17,304.04,112
HCPCS,J0475,"INJECTION, BACLOFEN, 10 MG",528.135,264.065,144.49,781.51,62
HCPCS,J0476,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",180.75,90.38,54.23,245.82,28
HCPCS,J0485,"INJECTION, BELATACEPT, 1 MG",14.505,7.25,4.42,1286.64,31
HCPCS,J0490,"INJECTION, BELIMUMAB, 10 MG",126.30499999999999,63.15,34.53,1677.59,62
HCPCS,J0491,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",41.805,20.905,11.59,2382.19,31
HCPCS,J0500,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",220.25,110.125,18.69,316.88,28
HCPCS,J0515,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",92.45,46.23,22.8,125.74,28
HCPCS,J0561,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",71.0,35.5,7.07,314.55,124
HCPCS,J0567,"INJECTION, CERLIPONASE ALFA, 1 MG",199.13,99.57,59.74,20978.86,31
HCPCS,J0572,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",28.0,14.0,7.06,44.67,84
HCPCS,J0574,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 6 MG, BUT LESS THAN OR EQUAL TO 10 MG BUPRENORPHINE",32.77,16.38,9.83,44.56,28
HCPCS,J0585,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",28.605,14.305,7.16,604.48,93
HCPCS,J0586,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",29.0,14.5,8.7,604.48,62
HCPCS,J0587,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",39.0,19.5,8.31,604.48,93
HCPCS,J0588,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",16.0,8.0,4.8,604.48,62
HCPCS,J0592,"INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG",28.53,14.26,5.43,295.12,56
HCPCS,J0612,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",1.4849999999999999,0.745,0.05,2.07,56
HCPCS,J0616,"INJECTION, METOPROLOL TARTRATE, 1 MG",14.829999999999998,7.414999999999999,0.2,54.4,28
HCPCS,J0636,"INJECTION, CALCITRIOL, 0.1 MCG",11.33,5.67,1.96,15.41,28
HCPCS,J0638,"INJECTION, CANAKINUMAB, 1 MG",401.0,200.5,120.3,9401.8,31
HCPCS,J0640,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",29.055,14.91,4.27,110.59,140
HCPCS,J0651,"INJECTION, LEVOTHYROXINE SODIUM (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0650, 10 MCG",26.83,13.41,8.05,36.48,27
HCPCS,J0665,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",233.0,116.5,0.02,316.88,28
HCPCS,J0670,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",24.33,12.17,6.19,33.09,28
HCPCS,J0675,"INJECTION, CARBOPROST TROMETHAMINE, 0.1 MG",284.58,142.29,115.83,387.03,20
HCPCS,J0689,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",22.32,11.16,1.77,52.7,56
HCPCS,J0690,"INJECTION, CEFAZOLIN SODIUM, 500 MG",27.67,13.83,1.37,195.74,308
HCPCS,J0692,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.8,15.9,1.44,108.29,252
HCPCS,J0694,"INJECTION, CEFOXITIN SODIUM, 1 GM",58.0,29.0,7.82,88.4,84
HCPCS,J0696,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",26.82,13.41,0.4,316.88,308
HCPCS,J0699,"INJECTION, CEFIDEROCOL, 10 MG",5.26,2.63,1.58,154.11,31
HCPCS,J0702,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",151.75,75.875,6.06,304.55,56
HCPCS,J0706,"INJECTION, CAFFEINE CITRATE, 5 MG",25.92,12.96,3.35,35.25,28
HCPCS,J0712,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",10.76,5.38,3.23,154.11,31
HCPCS,J0713,"INJECTION, CEFTAZIDIME, PER 500 MG",33.185,16.59,2.43,62.82,168
HCPCS,J0714,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",291.69,145.85,87.51,396.7,31
HCPCS,J0717,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",42.89,21.44,6.39,1677.59,31
HCPCS,J0735,"INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG",108.08,54.04,28.43,146.99,28
HCPCS,J0736,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",52.989999999999995,26.494999999999997,3.15,105.06,84
HCPCS,J0739,"INJECTION, CABOTEGRAVIR, 1MG, FDA APPROVED PRESCRIPTION, ONLY FOR USE AS HIV PRE-EXPOSURE PROPHYLAXIS (NOT FOR USE AS TREATMENT FOR HIV)",18.0,9.0,5.4,2382.19,31
HCPCS,J0740,"INJECTION, CIDOFOVIR, 375 MG",2832.4,1416.2,400.01,3852.06,31
HCPCS,J0741,"INJECTION, CABOTEGRAVIR AND RILPIVIRINE, 2MG/3MG",77.0,38.5,23.1,4737.06,62
HCPCS,J0743,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",30.0,15.0,9.0,40.8,28
HCPCS,J0770,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",118.29,59.14,19.93,160.87,28
HCPCS,J0780,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",30.09,15.04,4.16,78.98,28
HCPCS,J0791,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",437.01,218.51,131.1,1286.64,31
HCPCS,J0834,"INJECTION, COSYNTROPIN, 0.25 MG",199.625,99.815,21.0,448.8,112
HCPCS,J0870,"INJECTION, IMETELSTAT, 1 MG",198.26999999999998,99.13,47.67,11256.4,54
HCPCS,J0878,"INJECTION, DAPTOMYCIN, 1 MG",4.0,2.0,0.05,5.44,28
HCPCS,J0881,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",225.36,112.68,4.98,604.48,124
HCPCS,J0883,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",6.31,3.16,1.01,128.98,31
HCPCS,J0885,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",223.05,111.53,6.85,360.55,62
HCPCS,J0894,"INJECTION, DECITABINE, 1 MG",11.27,5.635,1.07,187.7,32
HCPCS,J0895,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",52.55,26.27,13.98,302.77,56
HCPCS,J0896,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",227.995,114.83,33.04,9401.8,62
HCPCS,J0897,"INJECTION, DENOSUMAB, 1 MG",117.72,58.86,13.02,1228.64,93
HCPCS,J0898,"INJECTION, ARGATROBAN (AUROMEDICS), NOT THERAPEUTICALLY EQUIVALENT TO J0883, 1 MG (FOR NON-ESRD USE)",2.02,1.01,0.61,128.98,32
HCPCS,J1010,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",1.87,0.935,0.12,292.95,56
HCPCS,J1071,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",220.38,110.19,0.05,316.88,56
HCPCS,J1100,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.36,1.8399999999999999,0.18,138.11,168
HCPCS,J1110,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",214.7,107.35,64.41,291.99,28
HCPCS,J1120,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",132.41500000000002,66.21000000000001,38.7,209.1,84
HCPCS,J1160,"INJECTION, DIGOXIN, UP TO 0.5 MG",49.83,24.915,12.0,80.55,28
HCPCS,J1163,"INJECTION, DILTIAZEM HYDROCHLORIDE, 0.5 MG",25.18,12.594999999999999,0.05,66.98,28
HCPCS,J1171,"INJECTION, HYDROMORPHONE, 0.1 MG",7.97,4.43,0.09,307.69,140
HCPCS,J1190,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",618.02,309.01,95.72,1195.91,62
HCPCS,J1200,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",57.84,28.92,1.17,316.88,56
HCPCS,J1205,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",102.4,51.2,30.72,139.26,28
HCPCS,J1230,"INJECTION, METHADONE HCL, UP TO 10 MG",86.23,43.115,24.38,124.0,56
HCPCS,J1250,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",68.16,34.08,13.23,103.79,56
HCPCS,J1265,"INJECTION, DOPAMINE HCL, 40 MG",25.645000000000003,12.825000000000001,1.32,59.63,56
HCPCS,J1271,"INJECTION, DOXYCYCLINE HYCLATE, 1 MG",33.915,16.96,0.17,90.11,28
HCPCS,J1299,"INJECTION, ECULIZUMAB, 2 MG",183.67000000000002,91.835,39.87,318.82,27
HCPCS,J1303,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",659.61,329.81,197.88,28568.47,31
HCPCS,J1304,"INJECTION, TOFERSEN, 1 MG",439.71,219.86,131.91,598.01,27
HCPCS,J1306,"INJECTION, INCLISIRAN, 1 MG",40.1,20.05,12.03,2382.19,31
HCPCS,J1308,"INJECTION, FAMOTIDINE, 0.25 MG",1.95,1.005,0.02,2.85,56
HCPCS,J1327,"INJECTION, EPTIFIBATIDE, 5 MG",26.62,13.31,5.81,47.67,31
HCPCS,J1335,"INJECTION, ERTAPENEM SODIUM, 500 MG",96.25,48.13,15.11,232.41,56
HCPCS,J1364,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",148.61,74.3,33.26,202.11,28
HCPCS,J1410,"INJECTION, ESTROGEN CONJUGATED, PER 25 MG",717.57,358.79,215.27,975.9,31
HCPCS,J1438,"INJECTION, ETANERCEPT, 25 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",3670.83,1835.42,694.74,4992.33,32
HCPCS,J1442,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",5.3149999999999995,2.66,1.24,306.0,62
HCPCS,J1448,"INJECTION, TRILACICLIB, 1MG",17.51,8.76,5.25,1286.64,31
HCPCS,J1450,"INJECTION FLUCONAZOLE, 200 MG",154.29000000000002,77.14500000000001,7.39,210.8,84
HCPCS,J1451,"INJECTION, FOMEPIZOLE, 15 MG",122.4,61.2,10.61,250.41,31
HCPCS,J1453,"INJECTION, FOSAPREPITANT, 1 MG",6.56,3.28,0.18,8.85,28
HCPCS,J1455,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",208.505,104.25,11.07,394.41,64
HCPCS,J1459,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",206.365,103.18,60.33,1677.59,248
HCPCS,J1561,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",254.24,127.12,76.27,1677.59,31
HCPCS,J1568,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",358.495,179.245,78.19,1677.59,31
HCPCS,J1569,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",199.055,99.525,59.67,2382.19,62
HCPCS,J1570,"INJECTION, GANCICLOVIR SODIUM, 500 MG",111.84,55.92,33.55,152.1,28
HCPCS,J1580,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",66.8,33.4,3.58,312.53,168
HCPCS,J1596,"INJECTION, GLYCOPYRROLATE, 0.1 MG",15.02,7.51,0.58,51.54,56
HCPCS,J1602,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",98.385,49.190000000000005,15.51,1677.59,31
HCPCS,J1610,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",340.89,170.445,65.1,874.99,93
HCPCS,J1628,"INJECTION, GUSELKUMAB, 1 MG",257.2,128.6,77.16,9401.8,31
HCPCS,J1630,"INJECTION, HALOPERIDOL, UP TO 5 MG",224.02,112.01,1.2,312.53,28
HCPCS,J1631,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",125.945,62.975,6.5,295.12,28
HCPCS,J1640,"INJECTION, HEMIN, 1 MG",79.59,39.79,22.98,4737.06,62
HCPCS,J1642,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.05,2.755,0.03,22.03,252
HCPCS,J1644,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.3149999999999995,3.21,0.3,295.12,448
HCPCS,J1650,"INJECTION, ENOXAPARIN SODIUM, 10 MG",220.72,110.36,0.87,316.88,336
HCPCS,J1652,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",116.37,58.185,1.45,316.88,56
HCPCS,J1720,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",64.59,32.295,14.8,160.37,84
HCPCS,J1742,"INJECTION, IBUTILIDE FUMARATE, 1 MG",637.0,318.5,145.38,866.32,31
HCPCS,J1745,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",236.17000000000002,118.08500000000001,53.49,1286.64,155
HCPCS,J1748,"INJECTION, INFLIXIMAB-DYYB (ZYMFENTRA), 10 MG",225.5,112.75,67.65,306.68,28
HCPCS,J1756,"INJECTION, IRON SUCROSE, 1 MG",2.8499999999999996,1.42,0.4,4.75,56
HCPCS,J1786,"INJECTION, IMIGLUCERASE, 10 UNITS",147.01,73.5,44.1,9401.8,31
HCPCS,J1790,"INJECTION, DROPERIDOL, UP TO 5 MG",148.54000000000002,74.27,11.85,304.33,28
HCPCS,J1800,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",68.635,34.32,16.58,111.52,56
HCPCS,J1805,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.195,2.5949999999999998,0.35,27.2,56
HCPCS,J1808,"INJECTION, FOLIC ACID, 0.1 MG",223.0,111.5,0.08,303.75,28
HCPCS,J1815,"INJECTION, INSULIN, PER 5 UNITS",9.725000000000001,4.82,0.39,89.01,532
HCPCS,J1817,"INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS",10.0,5.0,3.0,13.6,28
HCPCS,J1823,"INJECTION, INEBILIZUMAB-CDON, 1 MG",1619.16,809.58,485.75,20978.86,31
HCPCS,J1836,"INJECTION, METRONIDAZOLE, 10 MG",3.05,1.52,0.05,210.8,84
HCPCS,J1885,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",55.95,27.98,0.54,316.88,135
HCPCS,J1920,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",6.39,3.2,0.58,9.1,56
HCPCS,J1930,"INJECTION, LANREOTIDE, 1 MG",225.2,112.6,58.39,5897.78,93
HCPCS,J1932,"INJECTION, LANREOTIDE, (CIPLA), 1 MG",267.82,133.91,63.06,5897.78,31
HCPCS,J1938,"INJECTION, FUROSEMIDE, 1 MG",4.02,2.01,0.03,44.65,84
HCPCS,J1939,"INJECTION, BUMETANIDE, 0.5 MG",8.36,4.18,0.58,32.8,28
HCPCS,J1943,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA INITIO), 1 MG",14.77,7.39,4.43,1286.64,31
HCPCS,J1944,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",14.76,7.38,2.2,1677.59,93
HCPCS,J1950,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",576.0799999999999,288.03999999999996,170.85,7661.86,62
HCPCS,J1953,"INJECTION, LEVETIRACETAM, 10 MG",5.16,2.58,0.07,7.18,56
HCPCS,J1955,"INJECTION, LEVOCARNITINE, PER 1 GM",74.375,37.19,15.84,130.48,56
HCPCS,J1956,"INJECTION, LEVOFLOXACIN, 250 MG",62.77,31.385,3.56,103.19,56
HCPCS,J2003,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",3.2199999999999998,1.6099999999999999,0.08,314.55,84
HCPCS,J2004,"INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG",217.0,108.5,0.07,295.12,28
HCPCS,J2020,"INJECTION, LINEZOLID, 200 MG",44.25,22.13,4.52,60.18,28
HCPCS,J2021,"INJECTION, LINEZOLID (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J2020, 200 MG",27.02,13.51,8.11,36.74,28
HCPCS,J2060,"INJECTION, LORAZEPAM, 2 MG",60.55,30.28,2.33,295.12,56
HCPCS,J2151,"INJECTION, MANNITOL, 250 MG",157.95,78.97,64.29,214.81,20
HCPCS,J2175,"INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG",159.54500000000002,79.77,13.45,239.99,28
HCPCS,J2182,"INJECTION, MEPOLIZUMAB, 1 MG",141.54500000000002,70.77000000000001,20.61,2382.19,31
HCPCS,J2185,"INJECTION, MEROPENEM, 100 MG",8.88,4.44,0.63,33.33,84
HCPCS,J2186,"INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG (20MG)",5.06,2.53,1.52,154.11,31
HCPCS,J2210,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",217.0,108.5,35.24,292.95,28
HCPCS,J2212,"INJECTION, METHYLNALTREXONE, 0.1 MG",114.275,57.14,1.14,234.0,28
HCPCS,J2248,"INJECTION, MICAFUNGIN SODIUM, 1 MG",1.64,0.82,0.38,2.88,84
HCPCS,J2250,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",39.565,19.78,0.23,311.08,252
HCPCS,J2260,"INJECTION, MILRINONE LACTATE, 5 MG",28.68,14.34,2.23,47.51,56
HCPCS,J2265,"INJECTION, MINOCYCLINE HYDROCHLORIDE, 1 MG",5.59,2.8,1.68,7.6,27
HCPCS,J2267,"INJECTION, MIRIKIZUMAB-MRKZ, 1 MG",118.57,59.29,35.57,161.26,27
HCPCS,J2270,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",60.0,30.0,3.07,308.38,224
HCPCS,J2272,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",60.86,30.43,5.24,292.95,56
HCPCS,J2274,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",83.86,41.93,22.28,114.05,28
HCPCS,J2278,"INJECTION, ZICONOTIDE, 1 MICROGRAM",90.4,45.2,17.44,1677.59,31
HCPCS,J2300,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",64.0,32.0,5.69,87.04,28
HCPCS,J2305,"INJECTION, NITROGLYCERIN, 5 MG",19.895,9.95,2.51,34.7,56
HCPCS,J2312,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",44.035,22.02,0.12,306.0,140
HCPCS,J2315,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",118.025,59.01,3.54,1286.64,31
HCPCS,J2323,"INJECTION, NATALIZUMAB, 1 MG",80.44,40.22,23.06,5897.78,93
HCPCS,J2326,"INJECTION, NUSINERSEN, 0.1 MG",1920.53,960.26,576.16,28568.47,31
HCPCS,J2327,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",60.599999999999994,30.299999999999997,16.94,5897.78,31
HCPCS,J2329,"INJECTION, UBLITUXIMAB-XIIY, 1MG",238.33,119.17,71.5,20978.86,31
HCPCS,J2350,"INJECTION, OCRELIZUMAB, 1 MG",202.42,101.21,40.56,28568.47,31
HCPCS,J2353,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",234.515,117.25999999999999,4.66,5897.78,93
HCPCS,J2354,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",116.225,58.115,0.77,316.88,112
HCPCS,J2356,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",116.56,58.28,2.96,2382.19,31
HCPCS,J2357,"INJECTION, OMALIZUMAB, 5 MG",119.0,59.5,4.67,1677.59,62
HCPCS,J2359,"INJECTION, OLANZAPINE, 0.5 MG",221.0,110.5,1.34,309.15,28
HCPCS,J2371,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",1.84,0.92,0.02,2.51,28
HCPCS,J2404,"INJECTION, NICARDIPINE, 0.1 MG",1.28,0.64,0.12,1.75,28
HCPCS,J2405,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",11.285,5.640000000000001,0.15,227.67,140
HCPCS,J2428,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG",56.05,28.02,0.56,75.66,27
HCPCS,J2430,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",58.44,29.22,17.53,79.48,28
HCPCS,J2440,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",71.01,35.5,21.3,96.57,28
HCPCS,J2469,"INJECTION, PALONOSETRON HCL, 25 MCG",45.405,22.705,0.58,157.24,56
HCPCS,J2470,"INJECTION, PANTOPRAZOLE SODIUM, 40 MG",59.23,29.61,4.52,505.24,28
HCPCS,J2506,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",310.94,155.47,67.77,2382.19,62
HCPCS,J2540,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",12.51,6.25,1.29,17.01,28
HCPCS,J2543,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",21.5,10.75,1.8,63.32,140
HCPCS,J2545,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",334.67499999999995,167.33499999999998,61.41,5911.01,32
HCPCS,J2560,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",71.0,35.5,16.61,116.8,84
HCPCS,J2562,"INJECTION, PLERIXAFOR, 1 MG",226.96,113.48,6.81,5897.78,31
HCPCS,J2590,"INJECTION, OXYTOCIN, UP TO 10 UNITS",44.39,22.195,4.44,316.88,112
HCPCS,J2597,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",42.685,21.34,4.05,298.84,96
HCPCS,J2598,"INJECTION, VASOPRESSIN, 1 UNIT",11.215,5.609999999999999,0.87,18.07,112
HCPCS,J2679,"INJECTION, FLUPHENAZINE HCL, 1.25 MG",20.05,10.03,6.02,27.27,28
HCPCS,J2680,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",85.0,42.5,10.23,115.6,28
HCPCS,J2690,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",515.33,257.67,154.6,700.85,27
HCPCS,J2700,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",9.65,4.83,0.94,13.13,28
HCPCS,J2704,"INJECTION, PROPOFOL, 10 MG",2.76,1.38,0.15,25.86,112
HCPCS,J2710,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",3.23,1.62,0.97,4.4,28
HCPCS,J2720,"INJECTION, PROTAMINE SULFATE, PER 10 MG",8.29,4.15,2.49,11.28,28
HCPCS,J2760,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",747.1,373.55,69.9,1105.82,62
HCPCS,J2765,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",55.44,27.72,1.78,238.5,56
HCPCS,J2783,"INJECTION, RASBURICASE, 0.5 MG",1771.19,885.59,309.0,2414.98,31
HCPCS,J2785,"INJECTION, REGADENOSON, 0.1 MG",129.865,64.935,4.42,324.96,28
HCPCS,J2790,"INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)",552.0,276.0,121.68,750.72,64
HCPCS,J2791,"INJECTION, RHO(D) IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC), INTRAMUSCULAR OR INTRAVENOUS, 100 IU",45.0,22.5,7.97,128.98,32
HCPCS,J2795,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.2850000000000001,0.64,0.08,1.84,56
HCPCS,J2802,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",219.72,109.86,7.72,308.95,81
HCPCS,J2850,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",163.085,81.53999999999999,38.93,604.48,31
HCPCS,J2865,"INJECTION, SULFAMETHOXAZOLE 5 MG AND TRIMETHOPRIM 1 MG",2.28,1.14,0.07,3.1,28
HCPCS,J2916,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",29.51,14.76,3.65,122.13,56
HCPCS,J2919,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",7.95,3.98,0.27,100.46,308
HCPCS,J2997,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",488.97,244.49,78.9,810.22,217
HCPCS,J3010,"INJECTION, FENTANYL CITRATE, 0.1 MG",56.245000000000005,28.125,1.21,312.75,280
HCPCS,J3030,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",226.935,113.47,69.21,314.55,28
HCPCS,J3032,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",58.73,29.37,17.62,1286.64,31
HCPCS,J3055,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",161.85,33.34,19.7,969.68,54
HCPCS,J3101,"INJECTION, TENECTEPLASE, 1 MG",583.26,291.63,165.76,5897.78,62
HCPCS,J3105,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",221.0,110.5,4.08,304.45,28
HCPCS,J3111,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",73.27,36.64,13.6,1286.64,62
HCPCS,J3145,"INJECTION, TESTOSTERONE UNDECANOATE, 1 MG",4.0,2.0,1.2,736.42,31
HCPCS,J3230,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",221.66500000000002,110.83500000000001,39.22,316.88,28
HCPCS,J3240,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",5151.63,2575.815,118.83,20244.71,31
HCPCS,J3243,"INJECTION, TIGECYCLINE, 1 MG",4.36,2.18,0.92,5.93,28
HCPCS,J3245,"INJECTION, TILDRAKIZUMAB, 1 MG",449.0,224.5,134.7,9401.8,31
HCPCS,J3250,"INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG",224.585,112.295,65.79,296.04,28
HCPCS,J3260,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",13.72,6.86,3.16,28.86,56
HCPCS,J3262,"INJECTION, TOCILIZUMAB, 1 MG",33.19,16.59,3.72,1286.64,93
HCPCS,J3285,"INJECTION, TREPROSTINIL, 1 MG",54.59,27.3,14.87,604.48,93
HCPCS,J3301,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",12.915,6.455,1.22,219.29,84
HCPCS,J3357,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",251.81,125.905,3.79,9401.8,64
HCPCS,J3358,"USTEKINUMAB, FOR INTRAVENOUS INJECTION, 1 MG",70.175,35.09,14.6,4737.06,31
HCPCS,J3360,"INJECTION, DIAZEPAM, UP TO 5 MG",217.0,108.5,11.04,295.12,28
HCPCS,J3373,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",21.189999999999998,10.594999999999999,0.05,124.03,269
HCPCS,J3375,"INJECTION, VANCOMYCIN HYDROCHLORIDE (TYZAVAN), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG",2.4050000000000002,1.205,0.21,5.14,168
HCPCS,J3380,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",61.765,30.88,18.47,5897.78,31
HCPCS,J3410,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",220.2,110.1,21.45,295.12,28
HCPCS,J3411,"INJECTION, THIAMINE HCL, 100 MG",83.525,41.76,1.8,242.32,56
HCPCS,J3415,"INJECTION, PYRIDOXINE HCL, 100 MG",78.0,39.0,23.07,292.95,56
HCPCS,J3420,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",65.57,32.79,1.06,308.18,28
HCPCS,J3430,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",56.25,28.125,2.95,292.95,112
HCPCS,J3465,"INJECTION, VORICONAZOLE, 10 MG",4.085,2.04,1.1,322.32,112
HCPCS,J3473,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",12.27,6.13,0.36,638.55,112
HCPCS,J3475,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",18.75,9.38,0.68,872.44,252
HCPCS,J3480,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",9.95,4.975,0.2,741.2,476
HCPCS,J3486,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",133.815,66.91,15.1,295.12,28
HCPCS,J3489,"INJECTION, ZOLEDRONIC ACID, 1 MG",282.35,141.175,8.38,1727.19,84
HCPCS,J3490,UNCLASSIFIED DRUGS,35.81,17.905,3.17,347.53,312
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,51.2,25.6,1.82,736.81,78
HCPCS,J7030,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",98.86,49.43,3.28,140.08,84
HCPCS,J7040,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",102.85499999999999,51.425,2.13,140.08,112
HCPCS,J7042,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),25.75,12.88,2.16,69.16,84
HCPCS,J7050,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",101.48,50.74,1.09,199.85,168
HCPCS,J7060,5% DEXTROSE/WATER (500 ML = 1 UNIT),28.03,14.015,2.89,170.68,252
HCPCS,J7120,"RINGERS LACTATE INFUSION, UP TO 1000 CC",98.13,49.06,3.93,140.08,84
HCPCS,J7121,"5% DEXTROSE IN LACTATED RINGERS INFUSION, UP TO 1000 CC",102.32,51.16,8.14,140.08,56
HCPCS,J7168,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",6.385,3.19,1.85,2382.19,93
HCPCS,J7185,"INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U.",2.575,1.2850000000000001,0.6,2382.19,62
HCPCS,J7186,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3.26,1.63,0.98,4737.06,31
HCPCS,J7187,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",3.87,1.93,1.16,4737.06,31
HCPCS,J7189,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",5.9,2.95,1.77,5897.78,31
HCPCS,J7192,"FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED",6.0,3.0,1.8,5897.78,31
HCPCS,J7195,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",3.64,1.82,1.09,5897.78,31
HCPCS,J7197,"ANTITHROMBIN III (HUMAN), PER I.U.",10.59,5.3,3.18,5897.78,31
HCPCS,J7198,"ANTI-INHIBITOR, PER I.U.",7.0,3.5,2.1,5897.78,31
HCPCS,J7296,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM, (KYLEENA), 19.5 MG",3921.125,1960.565,570.27,6321.62,64
HCPCS,J7297,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",1879.0,939.5,380.51,3260.15,96
HCPCS,J7298,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",2692.0,1346.0,570.27,5185.97,96
HCPCS,J7300,INTRAUTERINE COPPER CONTRACEPTIVE (PARAGARD),3560.0,1780.0,121.68,5180.24,64
HCPCS,J7301,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (SKYLA), 13.5 MG",2906.0,1453.0,570.27,3952.16,32
HCPCS,J7307,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",2494.8900000000003,1247.4450000000002,570.27,4130.03,96
HCPCS,J7308,"AMINOLEVULINIC ACID HCL FOR TOPICAL ADMINISTRATION, 20%, SINGLE UNIT DOSAGE FORM (354 MG)",686.0,343.0,205.8,932.96,31
HCPCS,J7318,"HYALURONAN OR DERIVATIVE, DUROLANE, FOR INTRA-ARTICULAR INJECTION, 1 MG",64.89,32.45,10.76,604.48,31
HCPCS,J7321,"HYALURONAN OR DERIVATIVE, HYALGAN, SUPARTZ OR VISCO-3, FOR INTRA-ARTICULAR INJECTION, PER DOSE",789.5,394.75,120.4,1109.76,64
HCPCS,J7325,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",104.025,52.015,12.47,250.41,31
HCPCS,J7327,"HYALURONAN OR DERIVATIVE, MONOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",4236.86,2118.43,570.27,5762.12,31
HCPCS,J7500,"AZATHIOPRINE, ORAL, 50 MG",20.0,10.0,0.1,32.64,56
HCPCS,J7502,"CYCLOSPORINE, ORAL, 100 MG",16.785,8.395,2.99,26.9,56
HCPCS,J7503,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",1.4649999999999999,0.73,0.31,3.09,56
HCPCS,J7504,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",9273.99,4636.99,2782.2,12612.62,31
HCPCS,J7507,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",11.09,5.545,0.33,24.27,112
HCPCS,J7509,"METHYLPREDNISOLONE ORAL, PER 4 MG",8.155000000000001,4.075,0.23,17.63,56
HCPCS,J7510,"PREDNISOLONE ORAL, PER 5 MG",8.870000000000001,4.4350000000000005,1.52,16.32,56
HCPCS,J7511,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5113.725,2556.8599999999997,1504.0,7091.2,62
HCPCS,J7512,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.6550000000000002,1.3250000000000002,0.02,7.02,140
HCPCS,J7515,"CYCLOSPORINE, ORAL, 25 MG",6.69,3.35,0.87,9.1,28
HCPCS,J7516,"INJECTION, CYCLOSPORINE, 250 MG",261.0,130.5,78.3,354.96,28
HCPCS,J7517,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",6.87,3.44,0.25,30.78,84
HCPCS,J7518,"MYCOPHENOLIC ACID, ORAL, 180 MG",17.11,8.555,0.53,28.08,56
HCPCS,J7519,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1.69,0.85,0.51,604.48,32
HCPCS,J7520,"SIROLIMUS, ORAL, 1 MG",31.38,15.69,1.6,63.49,84
HCPCS,J7525,"TACROLIMUS, PARENTERAL, 5 MG",307.39,153.695,38.04,663.68,62
HCPCS,J7527,"EVEROLIMUS, ORAL, 0.25 MG",19.51,9.755,1.95,31.85,56
HCPCS,J7608,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",68.42,34.21,8.15,94.42,56
HCPCS,J7611,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",5.22,2.6100000000000003,0.43,10.66,28
HCPCS,J7613,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.39,1.69,0.12,5.38,56
HCPCS,J7614,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",11.56,5.78,0.13,15.72,28
HCPCS,J7620,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",12.07,6.03,0.33,27.2,28
HCPCS,J7626,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",28.43,14.22,1.73,38.67,28
HCPCS,J7639,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",116.7,58.35,35.01,158.71,32
HCPCS,J7644,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",11.105,5.555,0.66,15.14,56
HCPCS,J7682,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",32.58,16.29,9.61,45.05,56
HCPCS,J7999,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",98.97,49.485,15.6,210.79,78
HCPCS,J8499,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.81,12.9,7.74,35.1,26
HCPCS,J8501,"APREPITANT, ORAL, 5 MG",15.44,7.72,4.43,208.65,84
HCPCS,J8502,"INJECTION, APREPITANT (APONVIE), 1 MG",7.16,3.58,2.91,9.74,20
HCPCS,J8515,"CABERGOLINE, ORAL, 0.25 MG",19.88,9.94,2.03,44.88,56
HCPCS,J8530,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",10.93,5.46,3.0,14.86,28
HCPCS,J8540,"DEXAMETHASONE, ORAL, 0.25 MG",2.5,1.25,0.02,18.52,140
HCPCS,J8597,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",10.245000000000001,5.04,0.83,12.85,52
HCPCS,J8610,"METHOTREXATE; ORAL, 2.5 MG",20.31,10.16,0.25,27.62,28
HCPCS,J8700,"TEMOZOLOMIDE, ORAL, 5 MG",21.73,10.87,0.89,59.11,84
HCPCS,J9000,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",33.114999999999995,16.56,3.97,274.72,112
HCPCS,J9017,"INJECTION, ARSENIC TRIOXIDE, 1 MG",146.47,73.23,4.68,199.19,32
HCPCS,J9021,"INJECTION, ASPARAGINASE, RECOMBINANT, (RYLAZE), 0.1 MG",200.82999999999998,100.41499999999999,65.1,20978.86,31
HCPCS,J9022,"INJECTION, ATEZOLIZUMAB, 10 MG",221.92000000000002,110.96000000000001,66.13,9401.8,62
HCPCS,J9023,"INJECTION, AVELUMAB, 10 MG",278.84,139.42,83.65,5897.78,31
HCPCS,J9025,"INJECTION, AZACITIDINE, 1 MG",5.2,2.6,0.76,1207.95,64
HCPCS,J9026,"INJECTION, TARLATAMAB-DLLE, 1 MG",6156.0,3078.0,1668.6,10200.0,54
HCPCS,J9029,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",144843.75,72421.88,26951.36,196987.5,31
HCPCS,J9030,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",74.3,37.15,5.41,108.7,31
HCPCS,J9033,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",48.915,24.46,3.38,2382.19,31
HCPCS,J9035,"INJECTION, BEVACIZUMAB, 10 MG",364.71500000000003,182.35500000000002,71.1,2382.19,93
HCPCS,J9036,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG",96.31,39.245,18.2,2382.19,31
HCPCS,J9038,"INJECTION, AXATILIMAB-CSFR, 0.1 MG",267.16,133.58,80.15,363.34,27
HCPCS,J9039,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",722.55,361.27,216.76,5897.78,31
HCPCS,J9040,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",566.39,283.19,37.98,2885.16,84
HCPCS,J9041,"INJECTION, BORTEZOMIB, 0.1 MG",334.27500000000003,167.13500000000002,2.19,962.55,64
HCPCS,J9042,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",616.525,308.265,108.93,9401.8,31
HCPCS,J9043,"INJECTION, CABAZITAXEL, 1 MG",783.77,391.885,228.14,5897.78,31
HCPCS,J9045,"INJECTION, CARBOPLATIN, 50 MG",72.86,36.43,4.83,236.03,28
HCPCS,J9047,"INJECTION, CARFILZOMIB, 1 MG",128.875,64.44,30.75,1677.59,93
HCPCS,J9050,"INJECTION, CARMUSTINE, 100 MG",1063.92,531.96,319.18,2382.19,31
HCPCS,J9055,"INJECTION, CETUXIMAB, 10 MG",374.09000000000003,187.04500000000002,62.42,2382.19,62
HCPCS,J9060,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",43.545,21.77,3.48,93.77,28
HCPCS,J9061,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",74.25,37.125,18.46,5897.78,31
HCPCS,J9063,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",230.595,115.3,62.28,20978.86,31
HCPCS,J9065,"INJECTION, CLADRIBINE, PER 1 MG",126.74,63.37,12.24,250.36,31
HCPCS,J9075,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",4.78,2.39,0.74,9.26,81
HCPCS,J9100,"INJECTION, CYTARABINE, 100 MG",403.5,201.75,1.39,1035.0,84
HCPCS,J9118,"INJECTION, CALASPARGASE PEGOL-MKNL, 10 UNITS",265.745,132.875,66.01,9401.8,31
HCPCS,J9119,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",89.78,44.89,28.25,5897.78,31
HCPCS,J9120,"INJECTION, DACTINOMYCIN, 0.5 MG",1789.5,894.75,508.18,2433.72,31
HCPCS,J9130,"DACARBAZINE, 100 MG",64.17500000000001,32.085,6.8,86.56,28
HCPCS,J9144,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",645.375,322.685,49.93,4737.06,31
HCPCS,J9150,"INJECTION, DAUNORUBICIN, 10 MG",307.33,153.67,23.52,759.58,64
HCPCS,J9155,"INJECTION, DEGARELIX, 1 MG",30.35,15.18,7.34,705.84,62
HCPCS,J9171,"INJECTION, DOCETAXEL, 1 MG",69.86,34.925,1.07,132.38,96
HCPCS,J9173,"INJECTION, DURVALUMAB, 10 MG",426.9,213.45,77.4,2382.19,31
HCPCS,J9177,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",97.8,48.9,23.74,5897.78,62
HCPCS,J9179,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",318.0,159.0,96.25,1677.59,31
HCPCS,J9181,"INJECTION, ETOPOSIDE, 10 MG",9.145,4.575,1.08,24.35,56
HCPCS,J9185,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",402.28,201.14,120.68,547.09,28
HCPCS,J9190,"INJECTION, FLUOROURACIL, 500 MG",35.82,17.91,3.2,173.81,112
HCPCS,J9201,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",378.90999999999997,189.45499999999998,5.92,621.96,84
HCPCS,J9202,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",575.1600000000001,287.58000000000004,172.17,4072.06,64
HCPCS,J9203,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",1359.04,679.52,396.28,5897.78,31
HCPCS,J9205,"INJECTION, IRINOTECAN LIPOSOME, 1 MG",139.885,69.945,58.97,4737.06,31
HCPCS,J9206,"INJECTION, IRINOTECAN, 20 MG",33.28,16.64,2.95,56.13,28
HCPCS,J9208,"INJECTION, IFOSFAMIDE, 1 GRAM",291.5,145.75,40.99,434.95,112
HCPCS,J9209,"INJECTION, MESNA, 200 MG",22.46,11.23,2.81,115.55,28
HCPCS,J9211,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",166.17,83.08,44.98,225.99,32
HCPCS,J9217,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",805.0,402.5,183.28,2277.82,217
HCPCS,J9218,"LEUPROLIDE ACETATE, PER 1 MG",333.245,166.625,43.27,710.29,28
HCPCS,J9223,"INJECTION, LURBINECTEDIN, 0.1 MG",614.565,307.28,184.49,4737.06,31
HCPCS,J9226,"HISTRELIN IMPLANT (SUPPRELIN LA), 50 MG",51866.0,25933.0,88.32,140780.4,31
HCPCS,J9227,"INJECTION, ISATUXIMAB-IRFC, 10 MG",241.395,120.695,72.31,4737.06,31
HCPCS,J9228,"INJECTION, IPILIMUMAB, 1 MG",358.54,179.27,107.56,9401.8,31
HCPCS,J9229,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",6907.29,3453.65,1926.1,20978.86,31
HCPCS,J9260,"INJECTION, METHOTREXATE SODIUM, 50 MG",29.6,14.8,1.34,292.95,84
HCPCS,J9263,"INJECTION, OXALIPLATIN, 0.5 MG",71.125,35.56,0.08,97.03,28
HCPCS,J9264,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",65.77,32.88,13.5,1677.59,62
HCPCS,J9266,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",99065.685,49532.845,19791.36,134728.9,31
HCPCS,J9267,"INJECTION, PACLITAXEL, 1 MG",11.18,5.59,0.17,15.85,28
HCPCS,J9271,"INJECTION, PEMBROLIZUMAB, 1 MG",165.69,163.675,42.41,76954.35,93
HCPCS,J9272,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",826.3050000000001,413.155,210.18,9401.8,31
HCPCS,J9273,"INJECTION, TISOTUMAB VEDOTIN-TFTV, 1 MG",544.75,272.37,160.27,20978.86,31
HCPCS,J9280,"INJECTION, MITOMYCIN, 5 MG",513.745,256.875,21.76,1523.88,124
HCPCS,J9281,"MITOMYCIN PYELOCALYCEAL INSTILLATION, 1 MG",1219.01,609.5,365.7,20978.86,31
HCPCS,J9286,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",11069.725,5534.865,3799.94,17226.38,27
HCPCS,J9293,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",152.36,76.18,45.71,207.21,31
HCPCS,J9298,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",528.94,264.47,158.68,28568.47,31
HCPCS,J9299,"INJECTION, NIVOLUMAB, 1 MG",95.43,47.715,20.17,5897.78,31
HCPCS,J9301,"INJECTION, OBINUTUZUMAB, 10 MG",190.55,95.28,57.17,5897.78,31
HCPCS,J9303,"INJECTION, PANITUMUMAB, 10 MG",544.06,272.03,163.36,4737.06,31
HCPCS,J9305,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",306.18,78.88,2.8,1677.59,31
HCPCS,J9306,"INJECTION, PERTUZUMAB, 1 MG",40.735,20.365000000000002,9.97,4737.06,31
HCPCS,J9308,"INJECTION, RAMUCIRUMAB, 5 MG",125.91999999999999,62.96,37.82,5897.78,31
HCPCS,J9309,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",398.82,199.41,119.65,9401.8,62
HCPCS,J9312,"INJECTION, RITUXIMAB, 10 MG",272.405,136.2,81.76,4737.06,31
HCPCS,J9316,"INJECTION, PERTUZUMAB, TRASTUZUMAB, AND HYALURONIDASE-ZZXF, PER 10 MG",452.525,321.64,78.53,4737.06,62
HCPCS,J9317,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",103.63499999999999,51.815,31.09,1228.64,31
HCPCS,J9319,"INJECTION, ROMIDEPSIN, LYOPHILIZED, 0.1 MG",117.53,58.76,35.26,5897.78,31
HCPCS,J9321,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",263.03499999999997,131.515,42.72,755.78,54
HCPCS,J9325,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",222.29000000000002,111.14500000000001,50.68,5897.78,62
HCPCS,J9331,"INJECTION, SIROLIMUS PROTEIN-BOUND PARTICLES, 1 MG",274.86,137.43,82.46,9401.8,31
HCPCS,J9342,"INJECTION, THIOTEPA, NOT OTHERWISE SPECIFIED, 1 MG",866.2750000000001,433.14,14.62,1932.83,54
HCPCS,J9347,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",482.04,241.02,144.61,5897.78,31
HCPCS,J9349,"INJECTION, TAFASITAMAB-CXIX, 2 MG",50.305,25.15,15.07,4737.06,31
HCPCS,J9351,"INJECTION, TOPOTECAN, 0.1 MG",45.58,22.79,2.06,61.99,28
HCPCS,J9352,"INJECTION, TRABECTEDIN, 0.1 MG",1269.005,634.5,362.75,5897.78,32
HCPCS,J9353,"INJECTION, MARGETUXIMAB-CMKB, 5 MG",128.36,64.18,38.51,4737.06,31
HCPCS,J9354,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",143.17,71.59,42.95,4737.06,62
HCPCS,J9355,"INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG",362.45,181.23,108.74,2382.19,31
HCPCS,J9356,"INJECTION, TRASTUZUMAB, 10 MG AND HYALURONIDASE-OYSK",388.745,194.375,92.46,4737.06,31
HCPCS,J9358,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",85.18,42.59,25.56,2382.19,31
HCPCS,J9359,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",654.86,327.43,196.46,20978.86,31
HCPCS,J9360,"INJECTION, VINBLASTINE SULFATE, 1 MG",23.380000000000003,11.690000000000001,6.99,114.92,28
HCPCS,J9370,"VINCRISTINE SULFATE, 1 MG",66.03,33.015,13.45,248.32,28
HCPCS,J9380,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",116.7,61.5,34.96,4737.06,62
HCPCS,J9390,"INJECTION, VINORELBINE TARTRATE, 10 MG",66.66999999999999,33.334999999999994,8.98,90.77,28
HCPCS,J9395,"INJECTION, FULVESTRANT, 25 MG",425.05,212.525,6.66,777.92,32
HCPCS,L0120,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE, PREFABRICATED, OFF-THE-SHELF (FOAM COLLAR)",17.0,8.5,5.1,44.21,28
HCPCS,L0140,"CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR)",159.0,79.5,47.7,104.94,28
HCPCS,L0172,"CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO-PIECE, PREFABRICATED, OFF-THE-SHELF",158.22,79.11,47.47,236.71,28
HCPCS,L1830,"KNEE ORTHOSIS, IMMOBILIZER, CANVAS LONGITUDINAL, PREFABRICATED, OFF-THE-SHELF",79.125,39.565,15.3,239.91,56
HCPCS,L1833,"KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, OFF-THE SHELF",12858.75,6429.38,509.63,7946.71,28
HCPCS,L1930,"ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT",246.0,123.0,73.8,421.06,28
HCPCS,L3260,"SURGICAL BOOT/SHOE, EACH",22.0,11.0,6.6,29.92,28
HCPCS,L3675,"SHOULDER ORTHOSIS, VEST TYPE ABDUCTION RESTRAINER, CANVAS WEBBING TYPE OR EQUAL, PREFABRICATED, OFF-THE-SHELF",181.0,90.5,54.3,266.98,28
HCPCS,L3908,"WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED, PREFABRICATED, OFF-THE-SHELF",58.565,29.285,13.2,111.52,56
HCPCS,L8499,UNLISTED PROCEDURE FOR MISCELLANEOUS PROSTHETIC SERVICES,511.5,255.75,100.2,1228.08,112
HCPCS,L8501,TRACHEOSTOMY SPEAKING VALVE,374.0,187.0,112.2,246.84,28
HCPCS,L8509,"TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, INSERTED BY A LICENSED HEALTH CARE PROVIDER, ANY TYPE",859.5,429.75,134.48,1214.12,168
HCPCS,L8511,"INSERT FOR INDWELLING TRACHEOESOPHAGEAL PROSTHESIS, WITH OR WITHOUT VALVE, REPLACEMENT ONLY, EACH",99.0,49.5,29.7,121.79,28
HCPCS,L8512,"GELATIN CAPSULES OR EQUIVALENT, FOR USE WITH TRACHEOESOPHAGEAL VOICE PROSTHESIS, REPLACEMENT ONLY, PER 10",12.0,6.0,2.68,7.92,28
HCPCS,L8600,"IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL",16186.5,8093.25,1019.3,17894.81,56
HCPCS,L8603,"INJECTABLE BULKING AGENT, COLLAGEN IMPLANT, URINARY TRACT, 2.5 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",404.24,202.12,121.27,729.08,28
HCPCS,L8606,"INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE, INCLUDES SHIPPING AND NECESSARY SUPPLIES",3882.0,1941.0,252.88,2785.86,56
HCPCS,L8607,"INJECTABLE BULKING AGENT FOR VOCAL CORD MEDIALIZATION, 0.1 ML, INCLUDES SHIPPING AND NECESSARY SUPPLIES",1422.08,711.04,52.81,938.57,28
HCPCS,L8610,OCULAR IMPLANT,374.665,187.335,37.76,1138.35,56
HCPCS,L8613,OSSICULA IMPLANT,1626.14,813.07,418.46,1073.25,28
HCPCS,L8614,"COCHLEAR DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS",60580.15,30290.07,6663.82,37438.53,28
HCPCS,L8690,"AUDITORY OSSEOINTEGRATED DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS",5936.8,2968.4,1781.04,7966.53,28
HCPCS,L8699,"PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED",497.205,248.60500000000002,79.42,1579.78,112
HCPCS,P9011,"BLOOD, SPLIT UNIT",165.0,82.5,49.5,224.4,32
HCPCS,P9012,"CRYOPRECIPITATE, EACH UNIT",136.0,68.0,40.8,367.45,32
HCPCS,P9016,"RED BLOOD CELLS, LEUKOCYTES REDUCED, EACH UNIT",499.0,249.5,149.7,678.64,64
HCPCS,P9017,"FRESH FROZEN PLASMA (SINGLE DONOR), FROZEN WITHIN 8 HOURS OF COLLECTION, EACH UNIT",305.0,152.5,91.5,414.8,32
HCPCS,P9031,"PLATELETS, LEUKOCYTES REDUCED, EACH UNIT",331.0,165.5,99.3,450.16,32
HCPCS,P9033,"PLATELETS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",582.0,291.0,174.6,791.52,32
HCPCS,P9035,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",1781.5,890.75,346.65,2611.2,64
HCPCS,P9037,"PLATELETS, PHERESIS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",2430.0,1215.0,346.65,3304.8,64
HCPCS,P9040,"RED BLOOD CELLS, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1026.0,513.0,157.19,1395.36,64
HCPCS,P9045,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",343.51,171.75,57.87,490.96,124
HCPCS,P9047,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",360.5,180.25,87.58,490.96,93
HCPCS,P9054,"WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED, EACH UNIT",1204.0,602.0,157.19,1637.44,32
HCPCS,P9057,"RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT",1313.0,656.5,157.19,1785.68,32
HCPCS,P9059,"FRESH FROZEN PLASMA BETWEEN 8-24 HOURS OF COLLECTION, EACH UNIT",194.0,97.0,58.2,263.84,32
HCPCS,P9073,"PLATELETS, PHERESIS, PATHOGEN-REDUCED, EACH UNIT",1964.0,982.0,346.65,2671.04,32
HCPCS,Q0091,"SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LABORATORY",106.0,53.0,20.82,144.16,32
HCPCS,Q0138,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",8.67,2.925,0.59,250.41,62
HCPCS,Q0144,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",36.075,18.035,10.29,51.47,56
HCPCS,Q0162,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",2.1550000000000002,1.0750000000000002,0.02,23.42,140
HCPCS,Q0164,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",6.83,4.21,1.29,15.51,56
HCPCS,Q0167,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",26.57,13.28,2.23,36.13,28
HCPCS,Q0169,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",16.52,8.26,0.48,31.28,84
HCPCS,Q0481,"MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",22631.4,11315.7,2489.45,24334.14,28
HCPCS,Q0506,"BATTERY, LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY",2713.5,1356.75,814.05,1790.91,28
HCPCS,Q2009,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",39.03,19.515,2.21,61.06,54
HCPCS,Q2041,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",2961420.0,1480710.0,56281.85,4027531.2,29
HCPCS,Q2042,"TISAGENLECLEUCEL, UP TO 600 MILLION CAR-POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",1988949.0,994474.5,56281.85,2704970.64,29
HCPCS,Q2050,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",2049.68,1024.84,120.64,2787.56,31
HCPCS,Q4101,"APLIGRAF, PER SQUARE CENTIMETER",98.0,49.0,29.4,160.23,56
HCPCS,Q4104,"INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQUARE CENTIMETER",267.53,133.765,46.2,518.24,56
HCPCS,Q4107,"GRAFTJACKET, PER SQUARE CENTIMETER",346.29,173.15,103.89,470.96,28
HCPCS,Q4108,"INTEGRA MATRIX, PER SQUARE CENTIMETER",457.2,228.6,137.16,621.79,28
HCPCS,Q4116,"ALLODERM, PER SQUARE CENTIMETER",1108.825,554.415,34.82,2858.15,56
HCPCS,Q4118,"MATRISTEM MICROMATRIX, 1 MG",10.29,5.15,3.09,14.0,28
HCPCS,Q4124,"OASIS ULTRA TRI-LAYER WOUND MATRIX, PER SQUARE CENTIMETER",30.0,15.0,3.6,160.23,56
HCPCS,Q4130,"STRATTICE TM, PER SQUARE CENTIMETER",106.36,53.18,31.91,160.23,28
HCPCS,Q4132,"GRAFIX CORE AND GRAFIXPL CORE, PER SQUARE CENTIMETER",619.15,309.58,160.23,842.04,28
HCPCS,Q4148,"NEOX CORD 1K, NEOX CORD RT, OR CLARIX CORD 1K, PER SQUARE CENTIMETER",642.36,321.18,160.23,873.61,28
HCPCS,Q4155,"NEOXFLO OR CLARIXFLO, 1 MG",46.23,23.12,13.87,62.87,28
HCPCS,Q4156,"NEOX 100 OR CLARIX 100, PER SQUARE CENTIMETER",192.54,96.27,57.76,261.85,28
HCPCS,Q4158,"KERECIS OMEGA3, PER SQUARE CENTIMETER",304.0,152.0,47.28,6159.22,84
HCPCS,Q4159,"AFFINITY, PER SQUARE CENTIMETER",1705.0,852.5,160.23,2318.8,28
HCPCS,Q4186,"EPIFIX, PER SQUARE CENTIMETER",265.0,132.5,79.5,360.4,28
HCPCS,Q4187,"EPICORD, PER SQUARE CENTIMETER",1037.0,518.5,160.23,1410.32,28
HCPCS,Q5101,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",4.99,2.49,0.58,316.88,62
HCPCS,Q5103,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",221.945,110.97,31.97,1286.64,155
HCPCS,Q5105,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",41.06,20.53,0.75,316.88,160
HCPCS,Q5107,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",251.18,125.59,39.34,1286.64,31
HCPCS,Q5108,"INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG",377.88,188.94,67.6,1677.59,31
HCPCS,Q5110,"INJECTION, FILGRASTIM-AAFI, BIOSIMILAR, (NIVESTYM), 1 MICROGRAM",229.0,114.5,0.46,1104.39,62
HCPCS,Q5111,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",244.6,122.3,73.1,2382.19,62
HCPCS,Q5115,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",328.295,164.15,49.75,2382.19,31
HCPCS,Q5116,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",299.2,149.6,13.55,2382.19,62
HCPCS,Q5117,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",366.57,183.28,84.88,1677.59,31
HCPCS,Q5119,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",272.53,136.265,21.9,2382.19,31
HCPCS,Q5121,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",220.235,110.11500000000001,39.29,604.48,31
HCPCS,Q5125,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",2.32,1.16,0.39,303.11,124
HCPCS,Q9950,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",59.7,29.85,17.91,81.2,28
HCPCS,Q9956,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",161.25,80.63,48.38,219.31,28
HCPCS,Q9958,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",3.69,1.845,0.12,5.96,56
HCPCS,Q9961,"HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION, PER ML",4.0,2.0,0.43,5.44,28
HCPCS,Q9963,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",3.56,1.78,0.36,121.9,196
HCPCS,Q9966,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",7.89,3.95,0.66,10.73,28
HCPCS,Q9967,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",2.0,1.0,0.25,13.6,280
HCPCS,Q9968,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",27.53,13.764999999999999,1.82,66.62,54
HCPCS,Q9983,"FLORBETABEN F18, DIAGNOSTIC, PER STUDY DOSE, UP TO 8.1 MILLICURIES",9535.0,4767.5,2614.71,12967.6,27
HCPCS,S0145,"INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML",2095.565,1047.7849999999999,69.9,5383.06,30
HCPCS,S0190,"MIFEPRISTONE, ORAL, 200 MG",215.0,107.5,36.55,383.52,60
HCPCS,S2083,ADJUSTMENT OF GASTRIC BAND DIAMETER VIA SUBCUTANEOUS PORT BY INJECTION OR ASPIRATION OF SALINE,1387.0,693.5,416.1,1886.32,28
HCPCS,V2630,ANTERIOR CHAMBER INTRAOCULAR LENS,405.65,202.83,121.7,267.73,28
HCPCS,V2632,POSTERIOR CHAMBER INTRAOCULAR LENS,1214.06,607.03,83.27,40157.64,560
HCPCS,V2787,ASTIGMATISM CORRECTING FUNCTION OF INTRAOCULAR LENS,1038.0,519.0,311.4,1411.68,28
HCPCS,V2788,PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS,7560.115,3780.0550000000003,1076.87,13314.0,168
HCPCS,V2790,"AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE",3880.56,1940.28,1164.17,5277.56,28
HCPCS,V2797,"VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER HCPCS VISION CODE",2.0,1.0,0.6,10.69,28
HCPCS,V5014,REPAIR/MODIFICATION OF A HEARING AID,340.105,170.055,38.31,504.33,32
HCPCS,V5020,CONFORMITY EVALUATION,138.54,69.27,36.78,204.0,32
HCPCS,V5160,"DISPENSING FEE, BINAURAL",250.0,125.0,38.31,340.0,32
HCPCS,V5172,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE CANAL (ITC)",750.0,375.0,225.0,1020.0,28
HCPCS,V5181,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, BEHIND THE EAR (BTE)",932.145,466.07,289.29,1301.79,28
HCPCS,V5241,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",250.0,125.0,38.31,340.0,32
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC",1975.0,987.5,285.0,2686.0,28
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC",1662.5,831.25,285.0,2261.0,28
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE",3275.0,1637.5,285.0,4454.0,28
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE",1817.0149999999999,908.51,285.0,2241.17,28
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC",5407.14,2703.57,902.5,7353.71,28
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC",3877.275,1938.635,902.5,5174.18,28
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE",3350.0,1675.0,825.0,4147.5,28
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE",3647.4300000000003,1823.7150000000001,902.5,4944.77,28
HCPCS,V5264,"EAR MOLD/INSERT, NOT DISPOSABLE, ANY TYPE",151.06,75.53,14.25,227.66,28
HCPCS,V5265,"EAR MOLD/INSERT, DISPOSABLE, ANY TYPE",20.625,10.315000000000001,6.0,28.9,28
HCPCS,V5266,BATTERY FOR USE IN HEARING DEVICE,60.86,30.43,0.5,82.77,28
HCPCS,V5267,"HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIED",186.94,93.47,56.04,270.32,28
HCPCS,V5299,"HEARING SERVICE, MISCELLANEOUS",57.81,28.91,17.34,78.63,28
HCPCS,a4648,"TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH",153.0,76.5,21.6,273.36,364
HCPCS,j7030,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",103.0,51.5,3.28,140.08,28
HCPCS,v5221,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE",3525.0,1762.5,812.25,5270.0,56
HCPCS,v5230,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, GLASSES",450.0,225.0,135.0,739.9,28
HCPCS,v5240,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",250.0,125.0,38.31,340.0,32
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,899351.85,449675.93,151924.0,552042.81,26
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,617088.2,308544.1,117567.43,366166.16,26
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",628888.69,314444.34,22522.08,418115.21,28
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",338905.22,169452.61,10703.4,272858.73,28
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,503178.7,251589.35,122952.92,256621.14,24
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,242391.13,121195.57,55296.32,214075.0,24
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,454730.53,227365.26,66834.97,231912.57,24
MS-DRG,010,PANCREAS TRANSPLANT,256711.2,128355.6,36608.62,130922.71,24
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",314868.03,157434.01,10356.31,160582.69,28
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",162717.49,81358.75,3380.77,83050.98,28
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",77134.94,38567.47,939.64,56768.58,28
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,379019.32,189509.66,138113.0,236740.61,24
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,129490.13,64745.06,52702.48,116809.16,24
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,2834223.03,1417111.51,448021.55,1445453.74,26
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,278180.12,139090.06,13584.63,155007.49,28
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,289699.28,144849.64,19814.63,147746.63,28
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,160597.43,80298.72,11727.41,81904.69,28
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,197466.96,98733.48,11729.08,112881.18,28
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,158517.17,79258.58,18245.57,80843.76,28
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,160655.39,80327.69,6463.6,89565.44,28
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,105240.4,52620.2,5381.81,61248.13,28
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,124001.04,62000.52,8818.55,63240.53,28
MS-DRG,028,SPINAL PROCEDURES WITH MCC,215222.92,107611.46,11660.01,118357.5,28
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,107647.85,53823.93,8418.17,67205.11,28
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,47205.47,23602.74,560.2,43243.24,28
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,117507.82,58753.91,8272.55,88261.37,28
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,79405.14,39702.57,6321.56,41978.57,28
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,100087.47,50043.74,9374.33,51044.61,28
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,114751.26,57375.63,5766.74,76248.92,28
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,76697.38,38348.69,4403.38,47090.46,28
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,72068.34,36034.17,3594.6,38271.22,28
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,119438.16,59719.08,6305.25,64851.08,28
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,57923.42,28961.71,2232.92,31963.6,28
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,59399.7,29699.85,777.96,30293.85,28
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",211627.28,105813.64,7862.13,107929.91,28
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",80410.17,40205.09,6411.52,43312.19,28
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",64449.9,32224.95,5325.04,34033.96,28
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,51143.0,25571.5,1810.73,35079.98,28
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,31135.0,15567.5,702.35,19289.26,28
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,56327.45,28163.72,822.87,30078.4,28
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,48575.24,24287.62,592.63,24773.37,28
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,84345.28,42172.64,623.7,45762.75,33
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,48255.4,24127.7,2341.99,25522.02,29
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,87992.0,43996.0,508.2,44875.92,28
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,118435.97,59217.98,12874.34,60402.34,28
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,51580.9,25790.45,992.89,26306.26,28
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",98190.01,49095.0,8162.07,54312.11,28
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",79824.93,39912.47,9230.96,40710.72,28
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",56622.25,28311.13,10808.31,33360.23,28
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,82486.52,41243.26,1570.75,42068.13,28
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,57434.76,28717.38,784.03,29291.73,28
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,37516.77,18758.38,310.33,19133.55,27
MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,34426.33,17213.17,375.49,28931.92,27
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,31981.28,15990.64,330.94,17027.82,27
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,41104.86,20552.43,409.31,20963.48,27
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,81200.95,40600.47,1333.06,41412.48,28
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,44345.0,22172.5,591.38,22615.95,28
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,18296.0,9148.0,2154.56,14896.38,28
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,45892.85,22946.43,670.07,31603.11,28
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,35251.0,17625.5,2148.79,20305.73,28
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,83576.0,41788.0,2208.28,42623.76,28
MS-DRG,077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,50403.72,25201.86,937.31,30458.59,28
MS-DRG,078,HYPERTENSIVE ENCEPHALOPATHY WITH CC,39983.52,19991.76,333.57,20391.6,27
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,109623.68,54811.84,2607.83,55908.08,28
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,30304.59,15152.29,329.48,17642.42,27
MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,64930.58,32465.29,1256.0,45024.03,28
MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,46175.16,23087.58,1545.46,27495.86,28
MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,61935.66,30967.83,605.46,31587.19,28
MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,71215.55,35607.77,2001.28,44754.16,28
MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,39391.11,19695.56,724.35,25661.89,28
MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,29020.67,14510.33,442.98,18018.68,28
MS-DRG,088,CONCUSSION WITH MCC,50824.0,25412.0,13830.62,36554.9,28
MS-DRG,089,CONCUSSION WITH CC,28118.0,14059.0,11397.98,21641.32,26
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,18075.0,9037.5,57.3,16216.22,27
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,59682.11,29841.05,1676.51,34595.38,28
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,45952.23,22976.12,1191.49,23435.64,28
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,42246.69,21123.34,1310.05,21545.81,28
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,106867.36,53433.68,2901.39,69328.66,28
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,74589.27,37294.63,2198.41,50807.66,28
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,45081.75,22540.88,1711.77,50621.96,28
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,293813.69,146906.85,17025.14,149844.98,28
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,102533.89,51266.94,7029.64,52292.28,28
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,84336.63,42168.31,14134.9,44970.2,28
MS-DRG,100,SEIZURES WITH MCC,76049.99,38025.0,1727.79,38785.5,28
MS-DRG,101,SEIZURES WITHOUT MCC,27361.01,13680.51,389.7,17780.32,27
MS-DRG,102,HEADACHES WITH MCC,36390.52,18195.26,655.67,22080.61,28
MS-DRG,103,HEADACHES WITHOUT MCC,32740.83,16370.42,1367.54,16697.83,28
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,183408.83,91704.42,2029.22,93538.5,28
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,54501.01,27250.51,3215.07,27795.52,28
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,104499.61,52249.8,1646.36,53294.8,28
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,71298.54,35649.27,1409.94,36362.26,28
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,28981.07,14490.53,440.59,21371.45,28
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,23927.33,11963.67,354.0,22915.85,27
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,24121.0,12060.5,691.04,15479.47,28
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,56487.12,28243.56,4047.54,28808.43,28
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,53066.5,26533.25,2034.96,27063.92,28
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,30177.15,15088.57,474.8,15390.34,28
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,50411.65,25205.83,519.88,41667.32,28
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,47599.29,23799.65,312.63,24275.64,27
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,57883.08,28941.54,1452.39,29520.37,28
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,43164.46,21582.23,496.43,22013.88,28
MS-DRG,139,SALIVARY GLAND PROCEDURES,44540.97,22270.48,383.71,23808.21,27
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,226540.79,113270.39,6583.4,115535.8,28
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,138839.11,69419.56,6077.06,70807.95,28
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,154509.87,77254.93,14451.4,78800.03,28
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",122877.32,61438.66,4102.86,73804.27,28
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",72481.24,36240.62,1428.81,36965.43,28
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",40814.56,20407.28,469.33,23684.11,28
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",74834.68,37417.34,1314.01,41710.66,28
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",55898.72,27949.36,2045.23,28508.35,28
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",43789.17,21894.58,529.31,22332.47,28
MS-DRG,149,DYSEQUILIBRIUM,23523.67,11761.83,1118.06,14805.77,28
MS-DRG,150,EPISTAXIS WITH MCC,52096.33,26048.17,918.5,26569.13,28
MS-DRG,151,EPISTAXIS WITHOUT MCC,27017.97,13508.99,374.99,14459.07,27
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,37140.6,18570.3,702.5,23288.16,28
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,17652.42,8826.21,362.84,14541.8,27
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",57339.03,28669.52,1053.06,30799.39,28
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",32146.55,16073.27,564.74,18054.13,28
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",670.0,335.0,49.76,13564.22,27
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,35506.01,17753.0,1025.56,33819.24,28
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,36941.2,18470.6,725.98,18840.01,28
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,39379.89,19689.95,704.49,20083.74,28
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,128638.31,64319.15,2112.06,88286.98,28
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,74832.3,37416.15,1090.24,49720.28,28
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,58987.73,29493.87,555.49,37707.83,28
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,148079.75,74039.88,2948.22,75520.67,28
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,67269.19,33634.59,1181.25,35525.18,28
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,42408.75,21204.38,383.47,26916.71,27
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,110654.26,55327.13,6254.9,58632.1,28
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,43348.33,21674.17,1463.23,27058.55,28
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,32052.21,16026.1,767.53,16346.63,28
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,50435.13,25217.56,1619.31,30783.63,28
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,28620.94,14310.47,797.14,19226.22,28
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,12383.67,6191.83,268.42,14818.39,27
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,74506.72,37253.36,1763.27,37998.43,28
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,44888.15,22444.07,537.83,22892.96,28
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,1115.04,557.52,21.87,14602.49,27
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,112130.62,56065.31,5422.41,57186.61,28
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,27398.5,13699.25,303.23,20961.71,27
MS-DRG,186,PLEURAL EFFUSION WITH MCC,56156.29,28078.15,1383.9,30700.89,28
MS-DRG,187,PLEURAL EFFUSION WITH CC,53609.81,26804.9,2226.52,27341.0,28
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,57786.09,28893.05,1098.58,29470.91,28
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,31783.16,15891.58,462.88,24336.14,28
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,27733.44,13866.72,340.26,21820.58,27
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,24590.76,12295.38,248.24,16606.26,27
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,23182.0,11591.0,270.69,12646.76,27
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,43171.66,21585.83,932.09,25892.37,28
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,24736.02,12368.01,989.95,15875.42,28
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,11648.28,5824.14,95.76,12335.57,27
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,68716.36,34358.18,1218.22,37175.95,28
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,38025.89,19012.95,974.88,19393.21,28
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,44918.43,22459.22,423.37,22908.4,28
MS-DRG,199,PNEUMOTHORAX WITH MCC,81831.62,40915.81,1156.84,41734.13,28
MS-DRG,200,PNEUMOTHORAX WITH CC,28373.22,14186.61,587.22,21655.11,28
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,5601.5,2800.75,10.56,14035.27,27
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,27438.54,13719.27,501.74,19131.67,28
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,9362.0,4681.0,44.56,13150.09,27
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,34742.59,17371.29,454.33,17718.72,27
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,77733.39,38866.7,2138.18,39644.03,28
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,32215.77,16107.88,554.04,18538.73,28
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,178867.26,89433.63,3580.57,126757.16,28
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,113737.23,56868.61,2781.97,58005.99,28
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,432617.95,216308.98,25618.18,220635.16,28
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,220137.59,110068.8,8829.92,196142.94,28
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,266714.8,133357.4,11539.92,192711.38,28
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,268302.66,134151.33,11651.43,136834.36,28
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,245247.88,122623.94,18364.76,151254.83,28
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,190551.53,95275.76,31611.89,114501.34,28
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,140645.02,70322.51,26313.25,103605.33,28
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,205054.96,102527.48,16171.09,104578.03,28
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,129505.13,64752.56,12263.67,66047.62,28
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,76776.21,38388.11,562.86,165453.65,28
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,224852.12,112426.06,4411.93,150602.79,28
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,181679.12,90839.56,3343.28,107609.73,28
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,174235.65,87117.82,3607.28,115605.55,28
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,138122.61,69061.3,2581.3,82515.17,28
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,201956.9,100978.45,7969.48,102998.02,28
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,92545.76,46272.88,1518.76,56152.0,28
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,58003.75,29001.88,394.34,29581.91,27
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,90721.71,45360.86,6257.11,62894.97,28
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,86344.51,43172.25,6777.46,44035.7,28
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,77480.85,38740.42,6868.47,39515.23,28
MS-DRG,245,AICD GENERATOR PROCEDURES,225284.88,112642.44,21011.69,114895.29,28
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,96735.34,48367.67,3494.43,49335.02,28
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,104701.98,52350.99,12592.8,53398.01,28
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,135476.05,67738.03,4630.22,69092.79,28
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,118059.27,59029.64,7167.05,60210.23,28
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,75480.69,37740.34,2988.72,38495.15,28
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,34194.0,17097.0,458.43,52941.87,28
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,57450.21,28725.11,792.08,33446.93,28
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,74640.48,37320.24,5108.45,39833.35,28
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,71930.75,35965.38,3188.29,64076.91,28
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,60428.88,30214.44,1000.99,37240.96,28
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,57871.88,28935.94,4332.8,32107.4,28
MS-DRG,263,VEIN LIGATION AND STRIPPING,103790.7,51895.35,1655.35,60227.72,28
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,123007.93,61503.96,10437.85,65806.48,28
MS-DRG,265,AICD LEAD PROCEDURES,188816.91,94408.46,18283.75,96296.62,28
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,290878.81,145439.41,49735.32,148914.01,28
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,196586.71,98293.36,44821.03,123706.11,28
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,259954.32,129977.16,32951.49,137554.65,28
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,187455.85,93727.92,40894.77,95602.48,28
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,214401.38,107200.69,11066.1,109344.7,28
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,140615.5,70307.75,9973.59,71713.91,28
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,122599.42,61299.71,14930.24,62525.7,28
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,190619.01,95309.51,5512.75,97215.7,28
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,143291.76,71645.88,11155.69,73078.8,28
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,303137.45,151568.73,27376.74,154600.1,28
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,219524.18,109762.09,22192.87,118324.01,28
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,219909.01,109954.5,27663.59,112153.59,28
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,154072.56,77036.28,7337.2,109648.57,28
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,139814.92,69907.46,10300.17,71305.61,28
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",73570.09,36785.05,1301.03,37520.75,28
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",46360.27,23180.13,710.84,23643.74,28
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",33864.68,16932.34,545.41,17270.99,28
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",107388.01,53694.0,3631.98,54767.88,28
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",28849.0,14424.5,1075.96,14712.99,28
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",104873.13,52436.56,2029.02,53485.3,28
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",52794.49,26397.24,735.07,26925.19,28
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,78853.32,39426.66,1641.38,53309.43,28
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,52852.0,26426.0,927.04,33624.22,28
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,45228.33,22614.16,718.38,25289.58,28
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,31628.15,15814.08,507.07,16724.45,28
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,14022.0,7011.0,300.09,11149.63,27
MS-DRG,294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,20637.23,10318.62,392.72,24099.99,27
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",368415.0,184207.5,16204.71,187891.65,26
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,55011.08,27505.54,1078.99,32162.56,28
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,35946.61,17973.3,1501.81,21028.68,28
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,24416.98,12208.49,277.28,14177.37,27
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,33238.2,16619.1,542.23,23571.82,28
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,30500.44,15250.22,483.04,15555.23,28
MS-DRG,304,HYPERTENSION WITH MCC,37984.12,18992.06,518.13,23441.81,28
MS-DRG,305,HYPERTENSION WITHOUT MCC,25709.32,12854.66,547.62,14874.71,28
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,40192.2,20096.1,624.06,31041.68,28
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,23293.5,11646.75,303.36,17989.13,27
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,42614.48,21307.24,632.37,23717.6,28
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,29268.16,14634.08,307.93,14926.76,27
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,26856.77,13428.38,280.89,13696.95,27
MS-DRG,311,ANGINA PECTORIS,21049.0,10524.5,313.29,13826.73,27
MS-DRG,312,SYNCOPE AND COLLAPSE,35057.27,17528.63,738.07,17879.21,28
MS-DRG,313,CHEST PAIN,24946.13,12473.06,322.81,14183.28,27
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,71832.21,35916.1,1938.45,41076.35,28
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,38635.87,19317.94,1085.0,19704.29,28
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,29924.07,14962.04,570.46,15261.28,28
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,272560.53,136280.26,22075.39,139005.87,28
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,332669.2,166334.6,4130.64,169661.29,28
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,78250.33,39125.17,748.54,47382.0,28
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,104964.68,52482.34,3679.25,53597.04,28
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,76283.19,38141.6,3035.68,38904.43,28
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,214671.59,107335.8,10687.6,109482.51,28
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,121515.85,60757.93,1081.53,62071.55,28
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,208180.47,104090.24,6227.4,106172.04,28
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",162693.76,81346.88,3629.63,98246.79,28
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",113539.96,56769.98,2639.32,57905.38,28
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",73009.28,36504.64,1074.48,37234.74,28
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,169660.91,84830.45,4446.64,90546.45,28
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,102230.99,51115.5,1586.61,52137.81,28
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,67063.88,33531.94,855.81,34202.58,28
MS-DRG,333,RECTAL RESECTION WITH CC,111787.7,55893.85,1658.42,57011.73,28
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,79434.89,39717.45,644.84,40511.79,28
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,96199.8,48099.9,5006.04,70343.16,28
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,123334.52,61667.26,9431.51,62900.61,28
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,76452.58,38226.29,1776.25,38990.81,28
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,152200.53,76100.27,3196.96,77622.27,28
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,80473.49,40236.74,1561.32,41041.48,28
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,40277.87,20138.94,711.02,23366.95,28
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,68142.21,34071.11,844.16,34752.53,28
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,31515.94,15757.97,643.29,17149.95,28
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,98387.31,49193.65,12690.29,50177.53,28
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,49845.58,24922.79,670.82,30031.13,28
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,40393.19,20196.59,547.89,23004.49,27
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,61626.56,30813.28,1148.11,57166.5,28
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,93640.35,46820.18,13237.53,47756.58,28
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,58905.68,29452.84,3752.83,30041.9,28
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,197698.2,98849.1,6489.98,100826.08,28
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,81449.46,40724.73,1409.34,45810.02,28
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,58959.66,29479.83,741.31,30069.43,28
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,47421.9,23710.95,689.53,31358.84,28
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,42986.68,21493.34,673.96,21923.21,28
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,18183.64,9091.82,1083.29,15200.24,28
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,73479.5,36739.75,2317.09,37474.55,28
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,39187.4,19593.7,1330.57,20112.68,28
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,29500.24,14750.12,657.81,15045.12,28
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,73163.62,36581.81,1850.63,42130.25,28
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,59376.87,29688.44,1046.99,30282.2,28
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,9705.0,4852.5,186.11,18141.24,27
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,84548.58,42274.29,1374.46,43119.78,28
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,41802.7,20901.35,516.96,21319.38,28
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,33866.38,16933.19,470.82,17271.86,28
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,83233.2,41616.6,3789.98,42448.93,28
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,66752.21,33376.11,1543.21,34043.63,28
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,16570.23,8285.11,387.84,15771.02,27
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,71300.63,35650.31,6011.83,36363.32,28
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,42968.61,21484.31,3890.76,21913.99,28
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,54576.54,27288.27,1649.34,31169.73,28
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,44733.17,22366.59,1803.99,22813.92,28
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,41847.3,20923.65,2816.88,21342.12,28
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,61944.59,30972.29,1951.87,31591.74,28
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,31265.63,15632.81,1277.01,15945.47,28
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,23054.5,11527.25,592.51,11757.79,28
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",47734.12,23867.06,1026.09,24984.24,28
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",29426.81,14713.41,673.55,15357.34,28
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,60604.9,30302.45,1528.17,31504.61,28
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,41457.9,20728.95,1115.58,21143.53,28
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,34623.44,17311.72,614.74,17657.95,28
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,55503.01,27751.51,694.43,47177.14,28
MS-DRG,398,APPENDIX PROCEDURES WITH CC,53272.94,26636.47,1455.47,29816.41,28
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,45376.41,22688.21,570.18,23141.97,28
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,145311.19,72655.59,23293.85,85627.12,28
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",219159.2,109579.6,13301.45,111771.19,28
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",116517.63,58258.81,6545.69,59423.99,28
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",85438.15,42719.08,1783.08,43723.9,28
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,317641.85,158820.93,12044.26,161997.34,28
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,80651.59,40325.8,1765.92,42890.63,28
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,116526.39,58263.2,1528.36,59428.46,28
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,146991.29,73495.65,1594.61,74965.56,28
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,76888.78,38444.39,1809.37,40711.92,28
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,39862.52,19931.26,305.37,26855.65,27
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,93677.46,46838.73,1484.57,47775.5,28
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,72246.36,36123.18,1103.99,36845.64,28
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,60960.29,30480.14,836.35,31089.75,28
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,142991.99,71496.0,4281.08,72925.92,28
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,72815.98,36407.99,571.16,37136.15,28
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,205877.92,102938.96,11009.4,104997.74,28
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,140078.03,70039.01,16314.16,71439.79,28
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,446419.12,223209.56,85189.04,262341.74,28
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,299787.65,149893.82,54891.36,170654.18,28
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,228030.11,114015.06,46739.46,138073.3,28
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,284605.04,142302.52,24582.5,177480.11,28
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,235871.29,117935.64,28458.88,120294.36,28
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,89345.38,44672.69,2601.46,45566.14,28
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,40537.93,20268.96,951.8,20806.08,28
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,12999.0,6499.5,180.02,13984.24,27
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,76584.76,38292.38,2062.14,39058.23,28
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,45811.11,22905.56,1118.9,23363.67,28
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,46685.0,23342.5,302.35,23809.35,27
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,72673.1,36336.55,1522.43,37063.28,28
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,40124.27,20062.13,1927.37,20463.38,28
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,26550.05,13275.02,513.5,13540.53,28
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",108034.71,54017.35,2122.61,55097.7,28
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",43655.1,21827.55,1877.17,22264.1,28
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",37382.36,18691.18,344.8,19065.0,27
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,79243.15,39621.58,1258.2,40414.01,28
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,56207.86,28103.93,758.16,28666.01,28
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,39638.81,19819.41,469.25,20215.79,28
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,279637.38,139818.69,32756.78,142615.06,28
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,140322.86,70161.43,18912.79,83539.52,28
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,169698.8,84849.4,15103.29,104987.79,28
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,114546.91,57273.46,15323.11,64407.75,28
MS-DRG,453,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC,320786.76,160393.38,53044.01,190931.34,28
MS-DRG,454,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC,155410.45,77705.23,24717.35,120484.99,28
MS-DRG,455,COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC,106555.92,53277.96,17662.62,90725.71,28
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",290603.7,145301.85,43457.66,172198.14,28
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",249615.93,124807.96,42538.4,137341.82,28
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",217038.99,108519.5,40666.96,110689.89,28
MS-DRG,459,SPINAL FUSION EXCEPT CERVICAL WITH MCC,186445.58,93222.79,20024.37,130649.68,28
MS-DRG,460,SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,109709.05,54854.52,16337.74,72056.97,28
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,152930.25,76465.13,26909.56,108798.09,28
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,108723.9,54361.95,21270.7,64236.1,28
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,213845.63,106922.81,9493.38,112274.45,28
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,133665.44,66832.72,7658.05,68169.37,28
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,91173.8,45586.9,8775.64,46498.64,28
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,197824.9,98912.45,27814.96,107828.61,28
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,138421.36,69210.68,24070.89,79818.1,28
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,112101.27,56050.64,20923.74,65001.22,28
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,132714.67,66357.34,19450.73,67684.48,28
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,70006.67,35003.33,8392.29,37997.4,28
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,150704.61,75352.3,14314.87,95120.56,28
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,106046.02,53023.01,12321.09,58035.22,28
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,85146.72,42573.36,10252.01,48091.17,28
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,133842.03,66921.01,2479.28,84565.84,28
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,79605.73,39802.87,1289.39,44829.01,28
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,60292.77,30146.38,1317.8,30749.31,28
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,179657.67,89828.84,6213.25,91625.41,28
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,117672.38,58836.19,9373.7,60012.91,28
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,64736.18,32368.09,604.83,36618.47,28
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,169935.54,84967.77,10710.35,86667.13,28
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,107278.84,53639.42,7458.35,54712.21,28
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,70787.46,35393.73,3762.18,36101.61,28
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,117616.49,58808.24,22807.64,67769.56,28
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,99196.49,49598.25,5495.6,63570.64,28
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,83765.96,41882.98,3851.43,42720.64,28
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,66611.59,33305.79,1394.24,33971.91,28
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,90706.04,45353.02,8821.18,46260.08,28
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,40585.5,20292.75,545.72,21999.84,28
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",174211.17,87105.58,11282.26,88847.7,28
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",107148.88,53574.44,12163.54,54645.93,28
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",115097.28,57548.64,14655.85,58699.61,28
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,113663.24,56831.62,8582.76,71422.66,28
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,61560.99,30780.5,1369.71,35535.03,28
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,42510.14,21255.07,448.06,22687.34,28
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,134180.68,67090.34,15359.05,68432.15,28
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,47105.59,23552.8,2699.96,39689.55,28
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,111853.69,55926.85,10734.73,62343.4,28
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,87948.69,43974.35,4521.49,44853.83,28
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,53771.48,26885.74,849.62,27423.46,28
MS-DRG,504,FOOT PROCEDURES WITH CC,111385.32,55692.66,12719.28,56806.51,28
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,75451.17,37725.58,7847.2,38480.09,28
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,46729.05,23364.53,1031.47,35584.27,28
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",80094.74,40047.37,4246.83,59500.83,28
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",60530.63,30265.31,3554.73,40962.1,28
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",51245.31,25622.66,3492.95,32609.72,28
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",41320.68,20660.34,1029.21,31012.14,28
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",32770.03,16385.01,815.58,20138.29,28
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,120459.84,60229.92,6170.73,62778.74,28
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,88398.5,44199.25,1267.86,45083.23,28
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,58332.43,29166.21,725.27,30271.45,28
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,93534.88,46767.44,11077.19,73621.07,28
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,78100.89,39050.45,6207.13,39831.45,28
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,57143.0,28571.5,3385.56,29428.34,28
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,121521.32,60760.66,8358.72,61975.87,28
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,100983.99,50492.0,10975.21,51501.84,28
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,23953.14,11976.57,222.69,15879.36,27
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,83212.33,41606.17,1715.85,42438.29,28
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,33916.67,16958.33,291.74,17297.5,27
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",9508.0,4754.0,131.2,18730.05,27
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",20562.0,10281.0,467.86,14189.19,28
MS-DRG,539,OSTEOMYELITIS WITH MCC,45064.75,22532.37,797.57,38801.12,28
MS-DRG,540,OSTEOMYELITIS WITH CC,55530.53,27765.27,845.07,28320.57,28
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,75858.0,37929.0,1684.68,38687.58,28
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,51966.19,25983.1,689.95,26502.76,28
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,26038.34,13019.17,150.42,14864.87,27
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,54174.77,27087.39,2601.46,48887.01,28
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,49805.82,24902.91,5856.28,25400.97,28
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,27070.83,13535.42,4148.07,16907.27,28
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,26646.71,13323.36,152.69,37897.77,27
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,10350.0,5175.0,45.24,23693.71,27
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,8850.97,4425.49,291.23,17155.96,27
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,47643.18,23821.59,490.22,33017.49,28
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,28245.12,14122.56,396.96,18936.65,27
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,23544.5,11772.25,104.48,25442.48,27
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,36604.55,18302.28,1038.43,18668.32,28
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,37702.91,18851.46,516.23,26038.14,28
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,24058.55,12029.27,382.71,16361.99,27
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",100903.48,50451.74,2778.19,51460.77,28
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",21763.27,10881.64,461.84,17595.15,28
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",117987.62,58993.81,4663.37,60173.69,28
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",33526.4,16763.2,688.15,22183.04,28
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",35213.49,17606.75,324.97,17958.88,27
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",36689.25,18344.63,688.87,28067.14,28
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",32936.76,16468.38,363.93,17640.45,27
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,61144.46,30572.23,1325.33,31183.67,28
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,31103.83,15551.92,668.99,19194.71,28
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,31860.05,15930.03,470.5,16248.63,28
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,154672.2,77336.1,9595.66,78882.82,28
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,47752.09,23876.04,1004.88,33281.46,28
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,41119.58,20559.79,551.37,22580.96,28
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,198023.73,99011.87,6013.12,129056.03,28
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,94568.49,47284.24,4357.63,68383.11,28
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,47107.54,23553.77,7388.99,32180.29,28
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,202998.55,101499.27,16125.13,103529.26,28
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,95546.61,47773.31,3415.38,52216.14,28
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,62888.86,31444.43,2382.02,32073.32,28
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",107593.97,53796.99,2210.82,63795.21,28
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",81929.48,40964.74,1433.02,41784.04,28
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",48393.9,24196.95,822.64,28427.63,28
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,96646.76,48323.38,1516.47,49289.85,28
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,101002.03,50501.01,1397.57,51511.03,30
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",120169.03,60084.51,4735.91,61286.2,28
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",112363.64,56181.82,4302.81,57305.46,28
MS-DRG,592,SKIN ULCERS WITH MCC,29665.0,14832.5,516.87,37984.13,28
MS-DRG,593,SKIN ULCERS WITH CC,31094.55,15547.28,1505.7,23368.92,28
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,7684.0,3842.0,452.78,21482.0,28
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,105574.67,52787.33,17718.87,53843.08,28
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,32816.75,16408.38,5134.07,21582.03,28
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,46270.48,23135.24,1176.47,32840.2,28
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,39333.52,19666.76,2669.91,22285.48,28
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,8788.0,4394.0,179.83,14390.52,27
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,18667.88,9333.94,296.2,20443.48,27
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,20296.29,10148.15,574.28,11917.9,28
MS-DRG,602,CELLULITIS WITH MCC,57374.06,28687.03,1781.01,29260.77,28
MS-DRG,603,CELLULITIS WITHOUT MCC,25591.75,12795.88,1013.36,17155.86,28
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",41451.0,20725.5,588.87,28998.9,28
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",24778.15,12389.07,475.1,18044.28,33
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,34198.82,17099.41,439.15,29808.53,28
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,31971.81,15985.9,3997.27,17855.17,28
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,85505.42,42752.71,1135.75,43607.77,28
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,91145.49,45572.74,1144.35,46484.2,28
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",103044.33,51522.16,1522.14,68698.29,28
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",99934.07,49967.04,6421.37,50966.38,28
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,77675.93,38837.97,1513.03,56878.89,28
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,71805.02,35902.51,897.57,36620.56,28
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,57223.13,28611.56,781.39,29713.97,28
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",78380.84,39190.42,6842.44,70112.68,28
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",35114.5,17557.25,628.58,35208.88,28
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",5910.0,2955.0,2405.37,24571.04,26
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",179605.54,89802.77,3970.69,91598.82,28
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",67037.75,33518.87,573.56,34189.25,28
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",52051.4,26025.7,466.88,26546.22,28
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",100145.88,50072.94,1158.19,73414.23,28
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",98110.18,49055.09,1828.54,50036.19,28
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",26577.13,13288.57,306.5,28645.61,27
MS-DRG,637,DIABETES WITH MCC,50834.21,25417.11,1130.04,28301.55,28
MS-DRG,638,DIABETES WITH CC,26939.26,13469.63,537.35,17654.24,28
MS-DRG,639,DIABETES WITHOUT CC/MCC,15104.4,7552.2,100.36,12237.02,27
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",45823.62,22911.81,816.4,26309.98,28
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",30738.1,15369.05,794.48,15676.43,28
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,42670.52,21335.26,903.33,28013.95,28
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,66527.81,33263.91,1260.4,33929.18,28
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,29877.82,14938.91,833.32,20191.48,28
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,27375.9,13687.95,346.5,15134.74,27
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,272789.16,136394.58,48777.03,139122.47,26
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,265168.18,132584.09,38447.68,135235.77,26
MS-DRG,652,KIDNEY TRANSPLANT,265861.67,132930.84,38511.85,135589.45,24
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,164336.2,82168.1,4195.63,102363.88,28
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,99799.64,49899.82,1897.48,55143.41,28
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,78723.9,39361.95,909.65,41694.9,28
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,134992.07,67496.03,1847.72,68845.96,28
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,92708.28,46354.14,1062.6,47281.22,28
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,84240.94,42120.47,767.26,42962.88,28
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,205289.74,102644.87,7570.94,104697.77,28
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,59637.84,29818.92,912.93,30415.3,28
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,71054.07,35527.04,681.69,36237.58,28
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,89418.9,44709.45,3320.99,60308.49,28
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,68598.27,34299.14,9520.91,34985.12,28
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,68357.18,34178.59,563.24,34862.16,28
MS-DRG,665,PROSTATECTOMY WITH MCC,79398.8,39699.4,487.84,61484.52,28
MS-DRG,666,PROSTATECTOMY WITH CC,43340.99,21670.5,17639.78,34459.46,26
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,38984.75,19492.38,308.39,21791.03,27
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,70386.29,35193.15,2891.21,57521.08,28
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,57902.61,28951.3,1091.06,30572.85,28
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,47351.56,23675.78,10139.49,24149.3,26
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,39874.19,19937.1,394.34,35359.71,27
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,62214.01,31107.0,637.22,31729.14,28
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,117662.8,58831.4,3180.59,82767.32,28
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,80933.02,40466.51,2943.75,46068.08,28
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,50534.81,25267.41,1447.51,32333.94,28
MS-DRG,682,RENAL FAILURE WITH MCC,55381.53,27690.77,1120.24,29174.22,28
MS-DRG,683,RENAL FAILURE WITH CC,30070.44,15035.22,819.29,17252.38,28
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,16319.0,8159.5,164.15,11825.31,27
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,40900.28,20450.14,547.62,35531.09,28
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,46982.67,23491.34,703.36,23961.16,28
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,24426.75,12213.38,118.76,15568.12,27
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,46566.9,23283.45,745.62,23749.12,28
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,31347.95,15673.98,1088.6,15987.46,28
MS-DRG,693,URINARY STONES WITH MCC,49022.78,24511.39,1160.28,26485.31,28
MS-DRG,694,URINARY STONES WITHOUT MCC,21309.09,10654.55,548.03,15398.71,28
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,30150.34,15075.17,153.06,22531.72,27
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,27953.0,13976.5,107.07,14256.03,27
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,60634.55,30317.28,1570.67,32590.03,28
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,37404.54,18702.27,1434.55,19994.49,28
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,7401.5,3700.75,36.95,13540.67,27
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,92541.56,46270.78,1062.52,47196.2,28
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,89899.05,44949.52,584.1,45848.51,28
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,143573.07,71786.54,10163.13,73222.27,28
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,40861.08,20430.54,414.95,27602.24,27
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,144602.39,72301.2,5041.62,73747.22,28
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,21924.87,10962.44,8923.42,21662.99,26
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,59673.0,29836.5,525.78,30433.23,28
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,47061.53,23530.77,460.32,24001.38,28
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,230958.79,115479.39,8103.36,117788.98,28
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,76828.64,38414.32,3024.27,39182.6,28
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,164633.16,82316.58,19613.94,83962.91,26
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",88430.93,44215.47,1327.91,45099.78,28
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",47839.1,23919.55,1217.11,24397.94,28
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,47537.87,23768.94,7455.13,25796.56,28
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,18105.0,9052.5,21.87,14222.68,27
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,60852.35,30426.17,1232.14,31034.7,28
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,22010.29,11005.15,292.01,15979.83,27
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,18989.0,9494.5,648.44,13237.73,28
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",59147.61,29573.81,1849.56,41958.87,28
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",29971.11,14985.56,500.95,26505.0,28
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,103901.23,51950.61,1511.3,70414.08,28
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,90056.93,45028.47,1661.68,45929.04,28
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,64605.75,32302.87,698.39,32948.93,28
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,108464.87,54232.43,1515.03,69464.58,28
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,75901.09,37950.55,922.58,38709.56,28
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,62698.83,31349.42,513.74,31976.4,28
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,78576.44,39288.22,1253.77,40073.99,28
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,57316.63,28658.32,735.76,29231.48,28
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",92215.62,46107.81,1052.09,47029.97,28
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",47113.49,23556.75,662.65,24027.88,28
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",72035.24,36017.62,3840.94,36737.97,28
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",49820.85,24910.42,864.75,25408.63,28
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,77837.68,38918.84,1821.0,39697.21,28
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,106447.44,53223.72,3197.74,54288.2,28
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,63218.52,31609.26,4540.46,32241.45,28
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",58770.3,29385.15,1663.26,36279.65,28
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",41810.5,20905.25,779.76,21428.57,28
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",21558.71,10779.35,242.29,18920.89,27
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",155233.0,77616.5,4359.25,79168.83,28
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",25615.61,12807.8,391.51,19285.32,27
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",26885.42,13442.71,299.9,13711.56,27
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,23497.0,11748.5,723.6,19846.74,28
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,14920.33,7460.17,586.24,11220.55,28
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,31464.88,15732.44,587.33,21109.45,28
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,71531.77,35765.89,1189.3,36481.2,28
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",37131.46,18565.73,678.6,19752.19,28
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,31102.79,15551.4,623.7,15862.43,33
MS-DRG,779,ABORTION WITHOUT D&C,18891.72,9445.86,186.33,14047.36,27
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,45947.79,22973.89,830.53,48186.25,28
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,43199.49,21599.74,898.74,22031.74,28
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,29554.85,14777.42,621.73,18867.7,28
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,44725.21,22362.6,1242.93,32493.5,28
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,33777.5,16888.75,1048.33,21999.84,28
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,32433.93,16216.96,798.77,18887.4,28
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",149774.0,74887.0,96.89,76384.74,27
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",290167.26,145083.63,809.82,147985.31,28
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,89474.97,44737.49,626.01,79958.24,28
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,10198.93,5099.46,80.27,48070.45,27
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,31033.64,15516.82,409.41,81836.74,27
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,8031.05,4015.53,78.06,28967.49,27
MS-DRG,795,NORMAL NEWBORN,6019.93,3009.96,65.78,3935.86,27
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,20061.0,10030.5,360.04,22904.71,27
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,27636.28,13818.14,353.4,19706.88,27
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,20315.0,10157.5,303.11,18853.91,27
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,117657.04,58828.52,1293.87,89214.8,28
MS-DRG,800,SPLENIC PROCEDURES WITH CC,77747.97,38873.98,3439.37,55342.37,28
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,58781.74,29390.87,545.71,37603.42,28
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,125629.58,62814.79,2888.57,78482.79,28
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,62286.23,31143.11,551.51,36618.47,28
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,54978.93,27489.46,335.72,28039.25,27
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,25927.99,12963.99,645.12,21259.16,28
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,23166.09,11583.04,379.95,14853.05,27
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,20879.94,10439.97,314.52,13281.07,27
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,145602.61,72801.31,11079.04,74257.33,28
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,58525.32,29262.66,4176.39,29847.91,28
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,116652.01,58326.01,10858.48,59492.53,28
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,63099.49,31549.75,1382.14,32180.74,28
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,39225.93,19612.97,1143.98,20005.23,28
MS-DRG,813,COAGULATION DISORDERS,49424.01,24712.0,5654.03,30046.88,28
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,45042.98,22521.49,1343.81,41893.86,28
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,43798.02,21899.01,1358.71,22336.99,28
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,22324.3,11162.15,392.77,12449.77,27
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,48684.33,24342.16,697.65,33251.91,28
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,31955.97,15977.99,431.65,20766.69,27
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,33499.26,16749.63,500.56,17084.62,28
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,255509.2,127754.6,17331.3,130309.69,28
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,102213.92,51106.96,3239.56,52129.1,28
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,40452.64,20226.32,345.83,23717.6,27
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,235476.3,117738.15,9369.93,120092.91,28
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,80550.66,40275.33,1219.42,44630.05,28
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,75230.8,37615.4,2113.34,38367.71,28
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,194722.84,97361.42,8545.56,99308.65,28
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,82414.61,41207.3,1495.97,45528.33,28
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,68351.03,34175.51,1096.14,34859.02,28
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,104853.19,52426.6,6367.72,62248.84,28
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,50889.95,25444.98,274.46,29647.0,27
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,34544.73,17272.36,981.85,23688.05,28
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,19557.43,9778.72,295.45,14214.8,32
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,10180.74,5090.37,85.81,10262.96,32
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,227220.51,113610.25,10383.35,115882.46,28
MS-DRG,835,ACUTE LEUKEMIA WITH CC,185964.5,92982.25,13579.35,94841.89,28
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,140006.13,70003.06,8290.99,94639.91,28
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,63196.71,31598.35,5639.65,41119.69,28
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,52034.06,26017.03,5642.33,28443.39,28
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,161407.59,80703.8,8487.2,82317.87,28
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,93480.78,46740.39,3475.18,47675.2,28
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,48412.24,24206.12,1977.44,24690.24,28
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,64262.64,32131.32,1511.95,39295.57,28
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,41190.07,20595.03,477.86,23981.56,28
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,3198.0,1599.0,269.18,16714.35,27
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,78784.78,39392.39,7573.79,51069.66,28
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,38171.49,19085.75,5632.99,25770.23,28
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,41720.0,20860.0,4250.3,21277.2,28
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,185297.6,92648.8,5878.58,170583.49,28
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,199436.85,99718.43,8034.24,101712.79,28
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,94494.6,47247.3,1778.03,48192.25,28
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,51608.3,25804.15,546.65,29493.34,28
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,140112.29,70056.14,7230.9,89604.84,28
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,88021.81,44010.91,3886.14,44891.13,28
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,52667.52,26333.76,14451.34,27438.74,26
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,67832.15,33916.07,2164.96,35925.07,28
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,31135.96,15567.98,746.74,19657.63,28
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,22076.53,11038.27,380.55,17486.8,27
MS-DRG,865,VIRAL ILLNESS WITH MCC,68025.28,34012.64,3559.19,34692.9,28
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,26761.06,13380.53,642.21,17130.25,28
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,84322.57,42161.28,4293.8,43004.51,28
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,29817.42,14908.71,480.93,20311.64,28
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,23378.97,11689.49,905.68,14374.36,28
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,246064.15,123032.07,9801.17,136155.55,28
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,86802.58,43401.29,2804.16,44269.31,28
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,32902.47,16451.23,628.48,20157.99,28
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,97935.76,48967.88,1508.23,76134.67,28
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,21205.77,10602.88,288.39,18914.98,32
MS-DRG,881,DEPRESSIVE NEUROSES,28164.57,14082.29,97.29,18534.79,32
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,27259.01,13629.5,173.42,21152.79,32
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,17509.67,8754.83,157.33,38592.57,32
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,38865.65,19432.82,715.56,31693.72,33
MS-DRG,885,PSYCHOSES,37941.5,18970.75,272.25,27515.56,32
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,29601.0,14800.5,176.81,40731.91,27
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,26023.33,13011.67,29.03,21095.66,32
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",19550.22,9775.11,799.2,12152.31,28
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",36564.58,18282.29,1073.58,34376.72,28
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",22346.13,11173.07,630.09,17390.28,33
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,116985.51,58492.76,3130.68,82668.82,28
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,76205.86,38102.93,1367.62,38864.99,28
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,56860.95,28430.47,722.1,28999.08,28
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,58108.29,29054.15,973.34,72091.93,28
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,62813.52,31406.76,1046.55,32034.9,28
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,169418.56,84709.28,6866.94,86403.46,28
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,77289.71,38644.85,4890.28,39417.75,28
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,40165.9,20082.95,2550.21,25858.88,28
MS-DRG,913,TRAUMATIC INJURY WITH MCC,48701.0,24350.5,900.65,32199.99,28
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,20064.67,10032.33,171.66,17443.46,32
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,109723.81,54861.91,3960.9,55959.14,28
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,19645.82,9822.91,1357.09,13125.44,28
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,64802.04,32401.02,1401.64,33049.04,28
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,22572.06,11286.03,288.13,16884.01,32
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,88487.14,44243.57,6578.47,45128.44,28
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,34519.01,17259.51,908.44,19744.31,28
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,20311.56,10155.78,347.65,13560.79,27
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",35706.33,17853.17,531.44,34461.43,28
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",39649.0,19824.5,295.95,20220.99,27
MS-DRG,935,NON-EXTENSIVE BURNS,18319.5,9159.75,545.52,40431.62,28
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,163811.74,81905.87,11771.33,83543.99,28
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,89773.03,44886.52,8572.85,46034.59,28
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,79941.34,39970.67,14540.53,46799.9,28
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,45754.25,22877.13,2877.07,25005.91,28
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,28397.29,14198.65,428.67,15769.05,28
MS-DRG,949,AFTERCARE WITH CC/MCC,29727.0,14863.5,459.75,23435.9,28
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,3300.0,1650.0,1343.1,12319.87,26
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,14148.18,7074.09,464.34,10952.64,28
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",129219.14,64609.57,6799.44,74127.34,28
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,150104.49,75052.25,10283.97,150104.41,28
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,154350.68,77175.34,15999.79,83009.62,28
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,111742.15,55871.07,5960.47,56988.49,28
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,49505.0,24752.5,886.14,30190.69,28
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,28688.0,14344.0,187.75,18526.91,27
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,163200.19,81600.1,7319.46,120583.49,28
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,57505.83,28752.92,1566.06,56851.31,28
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,40669.2,20334.6,557.06,25510.21,28
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,17455.0,8727.5,100.66,17556.35,27
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,146146.06,73073.03,6897.22,74534.49,28
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,207997.84,103998.92,10491.44,106078.9,28
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,110571.49,55285.75,7400.73,56391.46,28
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,46053.84,23026.92,615.15,33764.09,28
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,120917.52,60458.76,2408.13,67536.05,28
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,66924.6,33462.3,1156.65,34131.55,28
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,52138.93,26069.46,458.1,26590.85,28
MS-DRG,998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,16675.0,8337.5,216.4,9171.25,12
NDC,00002-7510-01,"INJECTION, INSULIN, PER 5 UNITS",8.715,4.36,0.39,34.0,56
NDC,00002-7575-01,"INJECTION, MIRIKIZUMAB-MRKZ, 1 MG",118.57,59.29,35.57,161.26,27
NDC,00002-7669-01,"INJECTION, RAMUCIRUMAB, 5 MG",125.91999999999999,62.96,37.82,5897.78,31
NDC,00002-8215-01,"INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS",10.0,5.0,3.0,13.6,28
NDC,00002-8315-01,"INJECTION, INSULIN, PER 5 UNITS",23.11,11.555,0.87,50.32,56
NDC,00002-9401-01,"INJECTION, DONANEMAB-AZBT, 2 MG",14.74,7.37,4.42,20.05,27
NDC,00003-0371-13,"INJECTION, BELATACEPT, 1 MG",14.505,7.25,4.42,1286.64,31
NDC,00003-0494-20,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",13.415,6.705,1.22,24.29,28
NDC,00003-0894-21,ELIQUIS 5 MG TABLET,32.5,16.25,8.13,21.45,16
NDC,00003-2187-13,"INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",155.76,77.88,46.73,2382.19,31
NDC,00003-2327-11,"INJECTION, IPILIMUMAB, 1 MG",358.54,179.27,107.56,9401.8,31
NDC,00003-3772-11,"INJECTION, NIVOLUMAB, 1 MG",95.43,47.715,20.17,5897.78,31
NDC,00003-7125-11,"INJECTION, NIVOLUMAB AND RELATLIMAB-RMBW, 3 MG/1 MG",528.94,264.47,158.68,28568.47,31
NDC,00004-0261-29,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",22.63,11.32,0.25,30.78,28
NDC,00005-2000-01,"Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use",123.78,61.89,37.13,586.08,32
NDC,00006-3026-01,"INJECTION, PEMBROLIZUMAB, 1 MG",141.37,76.765,42.41,9401.8,31
NDC,00006-3061-01,"INJECTION, FOSAPREPITANT, 1 MG",6.56,3.28,0.18,8.85,28
NDC,00006-3516-59,"INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG",30.0,15.0,9.0,40.8,28
NDC,00006-4119-01,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",583.0,291.5,141.24,792.88,32
NDC,00006-4121-02,"Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent",759.18,379.59,56.4,1032.48,32
NDC,00006-4681-00,"Measles, mumps, and rubella vaccine",170.55,85.275,26.68,295.96,32
NDC,00006-4681-01,"Measles, mumps, and rubella vaccine",220.5,110.25,26.68,397.12,32
NDC,00006-4827-00,Varicella vaccine,310.44,155.22,58.56,648.72,32
NDC,00006-4837-01,"Pneumococcal vaccine, 23-valent",291.0,145.5,26.68,395.76,32
NDC,00006-5423-02,BRIDION 200 MG/2 ML VIAL,363.24,181.62,90.81,239.74,16
NDC,00006-5425-15,BRIDION 500 MG/5 ML VIAL,558.895,279.445,91.99,494.9,16
NDC,00008-0100-01,"INJECTION, INOTUZUMAB OZOGAMICIN, 0.1 MG",6907.29,3453.65,1926.1,20978.86,31
NDC,00008-4510-01,"INJECTION, GEMTUZUMAB OZOGAMICIN, 0.1 MG",1359.04,679.52,396.28,5897.78,31
NDC,00008-4990-19,"INJECTION, TIGECYCLINE, 1 MG",4.36,2.18,0.92,5.93,28
NDC,00009-0003-02,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.42,0.71,0.27,1.93,28
NDC,00009-0011-03,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",64.59,32.295,20.23,155.92,28
NDC,00009-0011-04,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",89.86,44.93,19.78,160.37,28
NDC,00009-0013-05,"INJECTION, HYDROCORTISONE SODIUM SUCCINATE, UP TO 100 MG",46.23,23.12,14.8,91.11,28
NDC,00009-0018-20,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.42,0.71,0.27,1.93,28
NDC,00009-0039-28,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",39.35,19.68,0.27,100.46,28
NDC,00009-0039-30,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",72.86,36.43,0.27,98.36,56
NDC,00009-0047-22,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.81,0.91,0.27,3.11,28
NDC,00009-0047-25,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.44,0.72,0.27,1.95,28
NDC,00009-0698-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.27,0.64,0.27,1.73,28
NDC,00009-0758-01,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",1.3399999999999999,0.6699999999999999,0.27,1.71,28
NDC,00009-0775-20,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",23.0,11.5,3.15,31.28,28
NDC,00009-0856-08,"INJECTION, CARBOPROST TROMETHAMINE, 0.1 MG",284.58,142.29,115.83,387.03,20
NDC,00009-3169-06,"INJECTION, ALPROSTADIL, 1.25 MCG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",2.17,1.09,0.65,2.96,28
NDC,00009-3475-01,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",109.045,54.52,0.12,292.95,28
NDC,00009-3794-01,"INJECTION, IBUTILIDE FUMARATE, 1 MG",637.0,318.5,145.38,866.32,31
NDC,00009-5140-01,"INJECTION, LINEZOLID (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J2020, 200 MG",27.02,13.51,8.11,36.74,28
NDC,00009-5140-01,"INJECTION, LINEZOLID, 200 MG",44.25,22.13,4.52,60.18,28
NDC,00009-7224-01,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, EQUINE, PARENTERAL, 250 MG",9273.99,4636.99,2782.2,12612.62,31
NDC,00023-1145-01,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",28.7,14.35,7.16,604.48,31
NDC,00023-3919-50,"INJECTION, ONABOTULINUMTOXINA, 1 UNIT",25.96,12.98,7.16,604.48,31
NDC,00023-5858-01,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (LILETTA), 52 MG",1868.81,934.41,380.51,1991.74,32
NDC,00024-0654-01,"INJECTION, ISATUXIMAB-IRFC, 10 MG",241.395,120.695,72.31,4737.06,31
NDC,00024-2792-10,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",29.51,14.76,3.65,43.18,28
NDC,00024-5150-10,"INJECTION, RASBURICASE, 0.5 MG",1771.19,885.59,309.0,2414.98,31
NDC,00024-5824-11,"INJECTION, CABAZITAXEL, 1 MG",783.77,391.885,228.14,5897.78,31
NDC,00024-5862-01,"INJECTION, PLERIXAFOR, 1 MG",226.96,113.48,6.81,5897.78,31
NDC,00024-5915-02,UNCLASSIFIED BIOLOGICS,541.77,270.89,162.53,736.81,26
NDC,00045-0449-10,ACETAMINOPHEN 500 MG TABLET,11.469999999999999,5.73,1.53,7.56,16
NDC,00046-0749-05,"INJECTION, ESTROGEN CONJUGATED, PER 25 MG",717.57,358.79,215.27,975.9,31
NDC,00049-0520-22,"INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS",12.51,6.25,1.29,17.01,28
NDC,00049-3190-28,"INJECTION, VORICONAZOLE, 10 MG",4.27,2.13,1.24,5.81,28
NDC,00052-0602-01,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",74.3,37.15,5.41,108.7,31
NDC,00054-0017-20,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",1.525,0.76,0.02,2.72,28
NDC,00054-0235-24,MORPHINE SULFATE IR 15 MG TAB,12.36,6.18,3.09,8.16,16
NDC,00054-0383-25,"CYCLOPHOSPHAMIDE; ORAL, 25 MG",10.93,5.46,3.0,14.86,28
NDC,00054-3177-63,"DEXAMETHASONE, ORAL, 0.25 MG",10.184999999999999,5.095,0.02,18.52,56
NDC,00054-3505-47,LIDOCAINE HCL 4% SOLUTION,113.56,56.78,21.89,125.44,32
NDC,00054-4741-25,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",5.16,2.58,0.02,7.02,28
NDC,00054-4742-25,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",3.54,1.77,0.02,4.82,28
NDC,00054-8146-22,CLOTRIMAZOLE 10 MG TROCHE,15.25,7.63,3.81,10.07,16
NDC,00054-8176-25,"DEXAMETHASONE, ORAL, 0.25 MG",1.55,0.77,0.02,3.4,28
NDC,00054-8179-25,"DEXAMETHASONE, ORAL, 0.25 MG",2.97,1.48,0.02,4.04,28
NDC,00054-8724-25,"PREDNISONE, IMMEDIATE RELEASE OR DELAYED RELEASE, ORAL, 1 MG",2.6550000000000002,1.3250000000000002,0.02,4.32,28
NDC,00065-0023-15,MIOSTAT VIAL,59.89,29.94,14.97,39.53,16
NDC,00065-0092-65,FLUORESCITE 10% VIAL,97.51,48.75,24.38,64.35,16
NDC,00065-0359-02,CYCLOMYDRIL EYE DROPS,119.0,59.5,29.75,78.54,16
NDC,00065-0395-15,CYCLOGYL 0.5% EYE DROPS,247.0,123.5,61.75,163.02,16
NDC,00065-0411-30,BETADINE 5% EYE SOLUTION,48.06,24.03,12.02,31.72,16
NDC,00065-0741-14,TETRACAINE 0.5% STERI-UNIT SOL,53.28,26.64,13.32,35.16,16
NDC,00069-0248-10,"INJECTION, PROPOFOL, 10 MG",2.58,1.29,0.15,25.86,56
NDC,00069-0249-01,"INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG",272.53,136.265,21.9,2382.19,31
NDC,00069-0305-01,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",299.39,149.69,13.55,2382.19,31
NDC,00069-0308-01,"INJECTION, TRASTUZUMAB-QYYP, BIOSIMILAR, (TRAZIMERA), 10 MG",299.01,149.51,13.55,2382.19,31
NDC,00069-0809-01,"INJECTION, INFLIXIMAB-DYYB (ZYMFENTRA), 10 MG",225.5,112.75,67.65,306.68,28
NDC,00069-0809-01,"INJECTION, INFLIXIMAB-DYYB, BIOSIMILAR, (INFLECTRA), 10 MG",222.06,111.03,31.97,1286.64,124
NDC,00069-1306-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",122.93,61.465,0.75,316.88,32
NDC,00069-1307-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",8.49,4.24,0.75,128.98,32
NDC,00069-1308-10,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",217.0,108.5,0.75,308.18,32
NDC,00069-1309-04,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",40.9,20.45,0.75,295.12,32
NDC,00069-1311-01,"INJECTION, EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR ESRD ON DIALYSIS), 100 UNITS",132.31,66.155,0.75,316.88,32
NDC,00069-3140-19,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",37.85,18.92,11.35,51.47,28
NDC,00069-3150-84,"INJECTION, AZITHROMYCIN, 500 MG",60.15,30.08,3.37,226.6,28
NDC,00069-5471-01,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",44.9,22.45,2.21,61.06,27
NDC,00071-1014-41,LYRICA 75 MG CAPSULE,21.82,10.91,5.45,14.4,16
NDC,00074-3109-32,"CYCLOSPORINE, ORAL, 100 MG",13.79,6.9,2.99,18.76,28
NDC,00074-3473-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1398.5,699.25,281.79,1901.96,31
NDC,00074-3641-03,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",575.66,287.83,170.85,7661.86,31
NDC,00074-3642-03,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",805.0,402.5,185.6,1400.8,31
NDC,00074-3663-03,"INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER 3.75 MG",576.5,288.25,184.48,4986.37,31
NDC,00074-4341-90,SYNTHROID 25 MCG TABLET,20.0,10.0,5.0,13.2,16
NDC,00074-4552-90,SYNTHROID 50 MCG TABLET,16.88,8.44,4.22,11.14,16
NDC,00074-5015-01,"INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG",60.599999999999994,30.299999999999997,16.94,5897.78,31
NDC,00074-6594-90,SYNTHROID 88 MCG TABLET,20.0,10.0,5.0,13.2,16
NDC,00074-7068-90,SYNTHROID 125 MCG TABLET,20.0,10.0,5.0,13.2,16
NDC,00074-9296-90,SYNTHROID 112 MCG TABLET,20.0,10.0,5.0,13.2,16
NDC,00078-0109-61,"INJECTION, CYCLOSPORINE, 250 MG",261.0,130.5,78.3,354.96,28
NDC,00078-0274-22,"CYCLOSPORINE, ORAL, 100 MG",19.78,9.89,2.99,26.9,28
NDC,00078-0414-20,"EVEROLIMUS, ORAL, 0.25 MG",15.6,7.8,1.95,21.21,28
NDC,00078-0415-20,"EVEROLIMUS, ORAL, 0.25 MG",23.42,11.71,1.95,31.85,28
NDC,00078-0467-61,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",68.66,34.33,13.98,302.77,28
NDC,00078-0797-61,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",240.82,120.41,64.12,5897.78,31
NDC,00078-0825-81,"INJECTION, OCTREOTIDE, DEPOT FORM FOR INTRAMUSCULAR INJECTION, 1 MG",226.515,113.25999999999999,4.66,5897.78,31
NDC,00078-0883-61,"INJECTION, CRIZANLIZUMAB-TMCA, 5 MG",437.01,218.51,131.1,1286.64,31
NDC,00078-1000-60,"INJECTION, INCLISIRAN, 1 MG",40.1,20.05,12.03,2382.19,31
NDC,00093-1177-01,NEOMYCIN 500 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00093-2026-31,"AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM",34.3,17.15,10.29,46.65,28
NDC,00093-2274-34,AMOX-CLAV 500-125 MG TABLET,23.33,11.665,3.5,21.98,16
NDC,00093-3657-21,BUPRENORPHINE 10 MCG/HR PATCH,183.43,91.72,45.86,121.07,16
NDC,00093-4148-45,"LEVALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 0.5 MG",11.56,5.78,0.13,15.72,28
NDC,00093-4177-73,CEPHALEXIN 250 MG/5 ML SUSP,23.0,11.5,5.75,15.18,16
NDC,00093-6815-73,BUDESONIDE 0.25 MG/2 ML SUSP,31.39,15.69,7.85,20.72,16
NDC,00093-7296-01,CARVEDILOL 25 MG TABLET,15.129999999999999,7.5649999999999995,2.57,12.56,16
NDC,00093-9018-19,"CYCLOSPORINE, ORAL, 25 MG",6.69,3.35,0.87,9.1,28
NDC,00116-2001-16,CHLORHEXIDINE 0.12% RINSE,15.68,7.84,3.92,10.35,16
NDC,00121-0431-30,MILK OF MAGNESIA SUSPENSION,20.0,10.0,5.0,13.2,16
NDC,00121-0759-08,"PREDNISOLONE ORAL, PER 5 MG",8.870000000000001,4.4350000000000005,1.52,16.32,56
NDC,00121-0865-05,DIPHENHYDRAMINE 12.5MG/5ML CUP,14.65,7.325,2.33,12.56,16
NDC,00121-1154-40,LACTULOSE 20 GM/30 ML SOLN CUP,30.0,15.0,7.5,19.8,16
NDC,00121-1276-10,GUAIFENESIN-DM 200-20 MG/10 ML,30.0,15.0,7.5,19.8,16
NDC,00121-1314-11,ACETAMINOPHEN 325 MG/10.15 ML,12.86,6.43,3.21,8.49,16
NDC,00121-1761-30,MAG-AL PLUS SUSPENS 30 ML CUP,20.0,10.0,5.0,13.2,16
NDC,00121-2316-15,HYDROCODONE-ACETAMN 7.5-325/15,15.86,7.93,0.38,19.93,32
NDC,00121-4950-15,LIDOCAINE 2% VISCOUS 15 ML CUP,21.5,10.75,5.38,16.15,16
NDC,00132-0119-46,FLEET ENEMA,12.36,6.18,2.32,9.32,16
NDC,00132-0202-20,FLEET PEDIA-LAX ENEMA,9.89,4.95,2.47,6.53,16
NDC,00132-0301-40,FLEET MINERAL OIL ENEMA,16.63,8.32,4.16,10.98,16
NDC,00143-9139-01,"INJECTION, CEFAZOLIN SODIUM, 500 MG",18.94,9.47,1.37,25.75,28
NDC,00143-9140-01,"INJECTION, CEFAZOLIN SODIUM, 500 MG",8.42,4.21,1.37,12.1,28
NDC,00143-9218-01,"INJECTION, IDARUBICIN HYDROCHLORIDE, 5 MG",166.17,83.08,44.98,225.99,32
NDC,00143-9240-01,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",197.67,98.83,37.98,268.83,28
NDC,00143-9247-01,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",576.0799999999999,288.03999999999996,95.72,834.33,31
NDC,00143-9250-10,ROCURONIUM 50 MG/5 ML VIAL,32.815,16.41,8.42,28.36,16
NDC,00143-9273-01,"INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG",214.7,107.35,64.41,291.99,28
NDC,00143-9279-01,"INJECTION, MITOMYCIN, 5 MG",529.975,264.985,43.07,709.89,31
NDC,00143-9280-01,"INJECTION, MITOMYCIN, 5 MG",442.75,221.38,43.07,602.14,31
NDC,00143-9392-01,REMIFENTANIL 2 MG VIAL,258.545,129.27,53.42,200.26,32
NDC,00143-9503-01,"INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG",135.58,67.79,38.78,209.1,56
NDC,00143-9506-01,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",5.2,2.6,0.2,7.07,28
NDC,00143-9519-01,METHOTREXATE 50 MG/2 ML VIAL,473.535,236.77,7.89,403.56,16
NDC,00143-9564-01,"INJECTION, PHENTOLAMINE MESYLATE, UP TO 5 MG",747.1,373.55,69.9,1105.82,62
NDC,00143-9710-01,"INJECTION, MILRINONE LACTATE, 5 MG",34.94,17.47,2.23,47.51,28
NDC,00143-9729-01,"INJECTION, BENZTROPINE MESYLATE, PER 1 MG",92.45,46.23,22.8,125.74,28
NDC,00143-9746-01,"INJECTION, TERBUTALINE SULFATE, UP TO 1 MG",221.0,110.5,4.08,304.45,28
NDC,00143-9784-01,FLUMAZENIL 0.5 MG/5 ML VIAL,58.85,29.42,14.71,38.84,16
NDC,00143-9785-01,VALPROATE SOD 500 MG/5 ML VL,47.76,23.88,11.94,31.52,16
NDC,00143-9786-10,ENALAPRILAT 2.5 MG/2 ML VIAL,79.26,39.63,19.82,52.31,16
NDC,00143-9856-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",13.355,6.675,0.76,27.2,28
NDC,00143-9857-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",13.254999999999999,6.63,0.76,19.25,56
NDC,00143-9872-01,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",55.27,27.64,16.58,75.17,28
NDC,00143-9873-25,"INJECTION, METOPROLOL TARTRATE, 1 MG",14.829999999999998,7.414999999999999,0.2,54.4,28
NDC,00143-9875-01,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.39,1.69,0.68,4.61,28
NDC,00143-9878-25,"INJECTION, CEFOXITIN SODIUM, 1 GM",65.0,32.5,7.82,88.4,28
NDC,00143-9983-03,"INJECTION, CEFAZOLIN SODIUM, 500 MG",12.5,6.25,1.37,17.0,28
NDC,00168-0004-80,TRIAMCINOLONE 0.1% CREAM,20.0,10.0,5.0,13.2,16
NDC,00168-0204-37,LIDOCAINE 5% OINTMENT,927.0,463.5,231.75,611.82,16
NDC,00169-1833-11,"INJECTION, INSULIN, PER 5 UNITS",10.0,5.0,0.87,13.6,28
NDC,00169-7202-01,"FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT), (NOVOSEVEN RT), 1 MICROGRAM",5.9,2.95,1.77,5897.78,31
NDC,00169-7501-11,"INJECTION, INSULIN, PER 5 UNITS",3.52,1.76,0.87,5.41,28
NDC,00173-0682-24,VENTOLIN HFA 90 MCG INHALER,114.495,57.25,24.33,81.38,16
NDC,00173-0881-01,"INJECTION, MEPOLIZUMAB, 1 MG",141.54500000000002,70.77000000000001,20.61,2382.19,31
NDC,00173-0898-03,"INJECTION, DOSTARLIMAB-GXLY, 10 MG",826.3050000000001,413.155,210.18,9401.8,31
NDC,00186-0370-28,SYMBICORT 160-4.5 MCG INHALER,782.75,391.38,195.69,516.62,16
NDC,00186-0372-28,SYMBICORT 80-4.5 MCG INHALER,782.75,391.38,195.69,516.62,16
NDC,00223-1760-02,SODIUM CHLORIDE 1 GM TABLET,20.0,10.0,5.0,13.2,16
NDC,00225-0805-47,NEO-SYNEPHRINE 0.5% SPRAY,37.55,18.78,9.56,27.16,16
NDC,00228-2127-10,CLONIDINE HCL 0.1 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00245-0108-01,FERROUS SULF EC 325 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00245-5319-89,KLOR-CON M20 TABLET,9.245000000000001,4.62,1.43,8.42,16
NDC,00259-1610-01,"INJECTION, INCOBOTULINUMTOXIN A, 1 UNIT",16.71,8.350000000000001,5.68,604.48,31
NDC,00264-1510-32,5% DEXTROSE/WATER (500 ML = 1 UNIT),23.585,11.79,2.89,170.68,168
NDC,00264-1800-32,UNCLASSIFIED DRUGS,31.06,15.53,3.17,347.53,156
NDC,00264-2201-00,SODIUM CHLORIDE 0.9% IRRIG.,103.0,51.5,25.75,67.98,16
NDC,00264-4460-10,NUTRILIPID 20% IV FAT EMULSION,99.09,49.54,24.77,65.4,16
NDC,00264-4460-30,NUTRILIPID 20% IV FAT EMULSION,99.14,49.57,24.5,69.63,64
NDC,00264-7805-10,SODIUM CHLORIDE 3% IV SOLN,103.0,51.5,25.75,67.98,16
NDC,00264-7865-00,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,14.01,28
NDC,00264-9872-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",147.195,73.6,0.3,196.38,28
NDC,00270-0445-35,"HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION, PER ML",5.445,2.725,0.36,121.9,168
NDC,00270-1111-02,"INJECTION, GADOLINIUM-BASED MAGNETIC RESONANCE CONTRAST AGENT, NOT OTHERWISE SPECIFIED (NOS), PER ML",7.84,3.92,2.33,22.56,28
NDC,00270-1315-25,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.7,0.85,0.25,2.31,28
NDC,00270-1316-30,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",2.51,1.25,0.25,3.41,28
NDC,00270-1316-95,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.47,0.735,0.25,2.56,56
NDC,00270-1410-30,"HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION, PER ML",4.38,2.19,0.12,5.96,28
NDC,00270-1411-11,"LOW OSMOLAR CONTRAST MATERIAL, 200-299 MG/ML IODINE CONCENTRATION, PER ML",7.89,3.95,0.66,10.73,28
NDC,00270-1412-15,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",6.09,3.04,0.25,8.28,28
NDC,00270-7025-40,"INJECTION, GADOPICLENOL, 1 ML",17.79,8.9,5.33,42.62,28
NDC,00270-7099-16,"INJECTION, SULFUR HEXAFLUORIDE LIPID MICROSPHERES, PER ML",59.7,29.85,17.91,81.2,28
NDC,00310-0720-10,"INJECTION, FULVESTRANT, 25 MG",425.05,212.525,6.66,777.92,32
NDC,00310-1110-01,LOKELMA 10 GRAM POWDER PACKET,30.0,15.0,7.5,19.8,16
NDC,00310-3040-00,"INJECTION, ANIFROLUMAB-FNIA, 1 MG",41.805,20.905,11.59,2382.19,31
NDC,00310-4535-30,"INJECTION, TREMELIMUMAB-ACTL, 1 MG",482.04,241.02,144.61,5897.78,31
NDC,00310-4611-50,"INJECTION, DURVALUMAB, 10 MG",426.9,213.45,77.4,2382.19,31
NDC,00338-0004-03,STERILE WATER FOR IRRIGATION,96.72,48.36,24.18,63.84,16
NDC,00338-0013-04,STERILE WATER FOR INJECTION,155.0,77.5,38.75,102.3,16
NDC,00338-0017-41,5% DEXTROSE/WATER (500 ML = 1 UNIT),100.67,50.34,2.89,136.91,28
NDC,00338-0023-02,DEXTROSE 10%-WATER IV SOLUTION,88.44,44.22,5.12,67.98,48
NDC,00338-0023-03,DEXTROSE 10%-WATER IV SOLUTION,103.0,51.5,25.75,67.98,16
NDC,00338-0023-04,DEXTROSE 10%-WATER IV SOLUTION,102.31,51.15,25.58,67.52,16
NDC,00338-0043-03,SODIUM CHLORIDE 0.45% SOLN,355.35,177.68,88.84,234.53,16
NDC,00338-0043-04,SODIUM CHLORIDE 0.45% SOLN,296.54499999999996,148.26999999999998,25.18,446.32,80
NDC,00338-0047-44,SODIUM CHLORIDE 0.9% IRRIG.,101.87,50.93,25.47,67.23,16
NDC,00338-0049-02,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",101.48,50.74,1.09,199.85,112
NDC,00338-0049-02,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",102.85499999999999,51.425,2.13,140.08,56
NDC,00338-0049-02,UNCLASSIFIED DRUGS,88.0,44.0,26.4,119.68,26
NDC,00338-0049-03,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",111.13499999999999,55.57,1.09,170.68,28
NDC,00338-0049-03,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",103.0,51.5,2.13,140.08,28
NDC,00338-0049-04,"INFUSION, NORMAL SALINE SOLUTION , 1000 CC",98.86,49.43,3.28,140.08,84
NDC,00338-0049-48,"INFUSION, NORMAL SALINE SOLUTION, 250 CC",102.52,51.26,1.09,139.43,28
NDC,00338-0049-48,"INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML = 1 UNIT)",103.0,51.5,2.13,140.08,28
NDC,00338-0054-03,SODIUM CHLORIDE 3% IV SOLN,101.6,50.8,25.05,67.98,32
NDC,00338-0072-25,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",130.84,65.42,0.54,316.88,27
NDC,00338-0077-04,DEXTROSE 5%-0.2% NACL IV SOLN,103.0,51.5,25.75,67.98,32
NDC,00338-0085-04,DEXTROSE 5%-0.45% NACL IV SOLN,102.66499999999999,51.335,6.25,82.83,64
NDC,00338-0089-04,5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT),25.75,12.88,2.16,69.16,84
NDC,00338-0117-04,"RINGERS LACTATE INFUSION, UP TO 1000 CC",98.13,49.06,3.93,140.08,84
NDC,00338-0125-04,"5% DEXTROSE IN LACTATED RINGERS INFUSION, UP TO 1000 CC",102.32,51.16,8.14,140.08,56
NDC,00338-0221-04,PLASMA-LYTE A PH 7.4 SOLN.,96.38,48.19,15.45,67.65,32
NDC,00338-0341-04,"CARDIOPLEGIC 16 MEQ K/1,000 ML",254.0,127.0,63.5,167.64,16
NDC,00338-0357-03,"INJECTION, MANNITOL, 250 MG",157.95,78.97,64.29,214.81,20
NDC,00338-0433-04,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",73.45,36.72,0.3,99.89,28
NDC,00338-0509-41,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",148.79000000000002,74.39500000000001,3.58,210.8,56
NDC,00338-0669-04,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",20.6,10.3,0.2,28.02,28
NDC,00338-0671-04,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.245000000000001,5.12,0.2,20.4,84
NDC,00338-0691-04,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",10.3,5.15,0.2,15.56,84
NDC,00338-0695-04,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",6.07,3.04,0.2,8.26,28
NDC,00338-0703-48,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",19.41,9.705,0.2,42.69,56
NDC,00338-0705-48,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",9.030000000000001,4.52,0.2,22.51,28
NDC,00338-0803-04,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",12.65,6.325,0.2,20.25,56
NDC,00338-1009-02,"INJECTION, DOPAMINE HCL, 40 MG",7.45,3.73,1.32,10.14,28
NDC,00338-1049-02,"INJECTION, NITROGLYCERIN, 5 MG",14.27,7.14,2.51,19.41,28
NDC,00338-1055-48,"INJECTION, METRONIDAZOLE, 10 MG",3.05,1.52,0.05,210.8,84
NDC,00338-1075-02,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",76.32,38.16,13.23,103.79,28
NDC,00338-3508-41,"INJECTION, CEFAZOLIN SODIUM (BAXTER), NOT THERAPEUTICALLY EQUIVALENT TO J0690, 500 MG",22.32,11.16,1.77,52.7,56
NDC,00338-3508-41,"INJECTION, CEFAZOLIN SODIUM, 500 MG",40.065,20.035,1.37,56.27,28
NDC,00338-3612-50,CLINDAMYCIN 600 MG/50 ML-D5W,155.0,77.5,38.75,102.3,16
NDC,00338-3612-50,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",73.95,36.975,3.15,105.06,28
NDC,00338-6010-48,"INJECTION, MILRINONE LACTATE, 5 MG",22.42,11.21,2.23,30.49,28
NDC,00338-9531-96,SODIUM CHLORIDE 0.9% 50 ML,101.84,50.92,5.38,82.83,16
NDC,00338-9553-50,"INJECTION, CLINDAMYCIN PHOSPHATE, 300 MG",50.98,25.49,3.15,74.25,28
NDC,00363-0700-08,SORE THROAT LOZENGES,115.68,57.845,6.78,131.1,16
NDC,00378-0871-16,CLONIDINE 0.1 MG/DAY PATCH,53.425,26.715,13.21,35.64,32
NDC,00378-0872-16,CLONIDINE 0.2 MG/DAY PATCH,65.46,32.73,16.36,43.2,16
NDC,00378-0873-16,CLONIDINE 0.3 MG/DAY PATCH,74.85,37.43,18.71,49.4,16
NDC,00378-7970-64,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",11.08,5.54,0.66,15.07,28
NDC,00378-9070-16,RIVASTIGMINE 4.6 MG/24HR PATCH,23.8,11.9,5.95,15.71,16
NDC,00378-9104-93,NITROGLYCERIN 0.2 MG/HR PATCH,11.35,5.68,2.84,7.49,16
NDC,00378-9124-16,FENTANYL 100 MCG/HR PATCH,277.85,138.925,30.06,286.05,16
NDC,00386-0001-13,ETHYL CHLORIDE SPRAY,99.5,49.75,24.88,65.67,16
NDC,00406-0123-23,HYDROCODONE-ACETAMIN 5-325 MG,21.18,10.59,3.71,18.84,16
NDC,00406-0125-62,HYDROCODONE-ACETAMIN 10-325 MG,30.0,15.0,7.5,19.8,16
NDC,00406-1236-01,DIPHENOXYLATE-ATROP 2.5-0.025,11.63,5.82,2.91,7.68,16
NDC,00406-9112-76,FENTANYL 12 MCG/HR PATCH,46.04,23.02,11.51,30.39,16
NDC,00406-9125-76,FENTANYL 25 MCG/HR PATCH,80.475,40.24,9.43,81.35,16
NDC,00406-9175-76,FENTANYL 75 MCG/HR PATCH,75.0,37.5,18.75,49.5,16
NDC,00407-2223-17,"LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CONCENTRATION, PER ML",1.26,0.63,0.25,1.71,28
NDC,00407-2707-03,"INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML",161.25,80.63,48.38,219.31,28
NDC,00409-0125-01,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",2.64,1.32,0.58,3.59,28
NDC,00409-0182-01,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",457.32,228.66,5.92,621.96,28
NDC,00409-0185-01,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",435.82,217.91,5.92,588.35,28
NDC,00409-0186-01,"INJECTION, GEMCITABINE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 200 MG",383.325,191.66,5.92,621.96,28
NDC,00409-0302-01,"INJECTION, TOPOTECAN, 0.1 MG",45.58,22.79,2.06,61.99,28
NDC,00409-1141-12,SODIUM CHLORIDE 400 MEQ/100 ML,57.51,28.76,14.38,37.96,16
NDC,00409-1273-32,"INJECTION, DIAZEPAM, UP TO 5 MG",217.0,108.5,11.04,295.12,28
NDC,00409-1283-03,"INJECTION, HYDROMORPHONE, 0.1 MG",7.07,3.53,0.09,234.92,28
NDC,00409-1312-16,"INJECTION, HYDROMORPHONE, 0.1 MG",222.33,111.17,0.09,307.69,28
NDC,00409-1434-01,"PRECEDEX 1,000 MCG/250 ML BTL",263.03,131.52,65.76,173.6,16
NDC,00409-1463-71,"INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG",64.0,32.0,5.69,87.04,28
NDC,00409-1630-15,"INJECTION, ATROPINE SULFATE, 0.01 MG",9.835,4.915,0.17,21.43,56
NDC,00409-1660-22,PRECEDEX 80 MCG/20 ML VIAL,98.31,49.16,24.58,64.88,16
NDC,00409-1660-55,PRECEDEX 200 MCG/50 ML BOTTLE,11.48,5.74,2.74,7.93,32
NDC,00409-1746-70,"MARCAINE 0.25%-EPI 1:200,000",45.5,22.75,11.37,30.03,16
NDC,00409-1749-71,"MARCAINE 0.5%-EPI 1:200,000 VL",49.96,24.98,12.49,32.97,16
NDC,00409-1755-50,"MARCAINE 0.5%-EPI 1:200,000 VL",67.9,33.95,16.98,44.81,16
NDC,00409-1886-22,"INJECTION, LEVETIRACETAM, 10 MG",5.28,2.64,0.07,7.18,28
NDC,00409-1890-03,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",75.15,37.58,5.02,102.21,28
NDC,00409-1966-02,BACTERIOSTATIC SALINE VIAL,31.700000000000003,15.850000000000001,3.71,34.96,32
NDC,00409-2051-15,KETAMINE 500 MG/5 ML VIAL,224.6,112.3,13.24,331.58,16
NDC,00409-2305-04,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",15.16,7.58,0.23,20.62,28
NDC,00409-2308-02,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",14.15,7.07,0.23,89.76,84
NDC,00409-2308-21,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",222.865,111.435,0.23,311.08,28
NDC,00409-2339-34,"INJECTION, LABETALOL HYDROCHLORIDE, 5 MG",6.54,3.27,0.58,9.1,28
NDC,00409-2344-68,"INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG",60.0,30.0,13.23,81.6,28
NDC,00409-2720-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",5.27,2.63,0.3,13.26,28
NDC,00409-2720-30,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",26.64,13.32,0.3,36.24,28
NDC,00409-2723-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",113.96,56.98,0.3,295.12,28
NDC,00409-3189-05,ROCURONIUM 50 MG/5 ML VIAL,12.18,6.09,3.05,8.04,16
NDC,00409-3299-05,SODIUM ACETATE 100 MEQ/50 ML,43.78,21.89,10.95,28.9,16
NDC,00409-3375-04,LEVOPHED 4 MG/4 ML VIAL,34.75,17.38,8.69,22.94,16
NDC,00409-3382-11,SUFENTANIL 50 MCG/ML VIAL,69.905,34.95,13.2,57.42,32
NDC,00409-3795-19,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",67.5,33.75,0.54,304.55,27
NDC,00409-3796-19,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",76.2,38.1,0.54,300.47,27
NDC,00409-4278-01,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",4.68,2.34,0.08,6.36,28
NDC,00409-4332-11,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",48.34,24.17,0.05,124.03,56
NDC,00409-4713-02,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",114.47999999999999,57.235,0.08,314.55,28
NDC,00409-4713-12,"INJECTION, LIDOCAINE HYDROCHLORIDE, 1 MG",1.76,0.88,0.08,2.39,28
NDC,00409-4759-01,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",13.105,6.55,0.15,26.44,28
NDC,00409-4887-10,"STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML",2.93,1.47,0.54,1.94,28
NDC,00409-4888-01,SODIUM CHLORIDE 0.9% VIAL,56.0,28.0,14.0,36.96,16
NDC,00409-4888-02,SODIUM CHLORIDE 0.9% VIAL,55.0,27.5,13.75,36.3,16
NDC,00409-5082-11,"INJECTION, CEFTAZIDIME, PER 500 MG",31.5,15.75,2.43,42.84,28
NDC,00409-5084-13,"INJECTION, CEFTAZIDIME, PER 500 MG",17.98,8.99,2.43,54.39,56
NDC,00409-5921-01,"INJECTION, AMINOPHYLLIN, UP TO 250 MG",15.3,7.65,4.59,20.81,28
NDC,00409-6102-04,"INJECTION, FUROSEMIDE, 1 MG",32.83,16.42,0.03,44.65,28
NDC,00409-6102-25,"INJECTION, FUROSEMIDE, 1 MG",3.985,1.9899999999999998,0.03,5.83,56
NDC,00409-6482-01,"INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG",148.61,74.3,33.26,202.11,28
NDC,00409-6533-11,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",18.29,9.145,0.05,44.88,56
NDC,00409-6533-59,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",38.99,19.49,0.05,53.02,28
NDC,00409-6557-01,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",220.38,110.19,0.05,304.31,28
NDC,00409-6625-22,SODIUM BICARBONATE 8.4% VIAL,80.27,40.14,20.07,52.98,16
NDC,00409-6648-02,DEXTROSE 50%-WATER VIAL,53.16,26.58,13.29,35.09,16
NDC,00409-6651-06,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",2.4,1.2,0.2,10.54,28
NDC,00409-6729-23,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",12.725,6.365,0.68,25.5,28
NDC,00409-6729-24,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",38.144999999999996,19.07,0.68,52.53,28
NDC,00409-7332-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",25.68,12.84,0.76,77.71,28
NDC,00409-7335-03,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",7.57,3.78,0.4,246.98,28
NDC,00409-7391-72,SODIUM PHOSPHATE 45 MMOL/15 ML,117.25,58.63,24.88,84.46,16
NDC,00409-7517-16,DEXTROSE 50%-WATER SYRINGE,64.0,32.0,12.23,43.98,16
NDC,00409-8183-01,POTASSIUM ACET 40 MEQ/20 ML VL,20.89,10.44,5.22,13.79,16
NDC,00409-9094-22,"INJECTION, FENTANYL CITRATE, 0.1 MG",64.0,32.0,1.96,87.04,28
NDC,00409-9104-20,"INJECTION, DOPAMINE HCL, 40 MG",43.84,21.92,1.32,59.63,28
NDC,00409-9157-31,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",67.08,33.54,4.64,292.95,84
NDC,00409-9158-31,"INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG",10.775,5.390000000000001,2.95,13.38,28
NDC,00436-0936-16,DAKIN'S 0.25% SOLUTION,52.925,26.465,11.34,39.91,16
NDC,00436-0946-16,DAKIN'S 0.5% SOLUTION,61.0,30.5,15.25,40.26,16
NDC,00456-0600-01,"INJECTION, CEFTAROLINE FOSAMIL, 10 MG",10.76,5.38,3.23,154.11,31
NDC,00456-2010-01,LEXAPRO 10 MG TABLET,13.79,6.9,3.45,9.1,16
NDC,00456-2700-01,"INJECTION, CEFTAZIDIME AND AVIBACTAM, 0.5 G/0.125 G",291.69,145.85,87.51,396.7,31
NDC,00469-0607-73,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",12.97,6.48,0.33,17.63,28
NDC,00469-0657-73,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",2.52,1.26,0.33,3.42,28
NDC,00469-3016-01,"TACROLIMUS, PARENTERAL, 5 MG",126.78,63.39,38.04,433.04,31
NDC,00469-3051-30,"INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG",101.11500000000001,50.555,15.42,736.42,31
NDC,00469-6501-89,"INJECTION, REGADENOSON, 0.1 MG",129.865,64.935,4.42,324.96,28
NDC,00472-0082-16,"PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS",25.81,12.9,7.74,35.1,26
NDC,00487-2784-01,ASTHMANEFRIN RFILL 2.25% SOLN,16.715,8.355,4.15,11.11,16
NDC,00487-9003-30,SODIUM CHLORIDE 3% VIAL,17.71,8.85,4.43,11.69,16
NDC,00487-9501-01,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",3.96,1.98,0.12,5.38,28
NDC,00487-9501-25,ALBUTEROL SUL 2.5 MG/3 ML SOLN,8.32,4.16,2.08,5.49,16
NDC,00487-9501-25,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG",2.9000000000000004,1.4449999999999998,0.12,4.33,28
NDC,00487-9701-01,"BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MG",28.43,14.22,1.73,38.67,28
NDC,00487-9901-30,ALBUTEROL 2.5 MG/0.5 ML SOL,9.079999999999998,4.539999999999999,2.14,6.35,32
NDC,00487-9901-30,"ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG",5.22,2.6100000000000003,0.43,10.66,28
NDC,00517-0374-01,PROVAYBLUE 50 MG/10 ML AMPULE,938.8799999999999,469.43999999999994,201.2,736.33,16
NDC,00517-0710-01,"INJECTION, FOMEPIZOLE, 15 MG",122.4,61.2,10.61,250.41,31
NDC,00517-0720-01,"INJECTION, BETAMETHASONE ACETATE 3 MG AND BETAMETHASONE SODIUM PHOSPHATE 3 MG",151.75,75.875,6.06,304.55,56
NDC,00517-0740-01,"INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG",217.0,108.5,35.24,292.95,28
NDC,00517-0955-01,"INJECTION, OLANZAPINE, 0.5 MG",221.0,110.5,1.34,309.15,28
NDC,00517-1001-01,"INJECTION, ATROPINE SULFATE, 0.01 MG",1.54,0.77,0.17,2.09,28
NDC,00517-1004-01,"INJECTION, ATROPINE SULFATE, 0.01 MG",113.44,112.61,0.17,304.04,28
NDC,00517-2310-01,"INJECTION, IRON SUCROSE, 1 MG",3.3049999999999997,1.65,0.4,4.14,28
NDC,00517-2340-10,"INJECTION, IRON SUCROSE, 1 MG",2.2199999999999998,1.11,0.4,4.75,28
NDC,00517-2502-01,CAFFEINE-SOD BENZOAT 250 MG/ML,103.71,51.85,25.93,68.45,16
NDC,00517-4300-01,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",64.88,32.44,13.5,1677.59,31
NDC,00517-4810-25,"INJECTION, NITROGLYCERIN, 5 MG",25.52,12.76,2.51,34.7,28
NDC,00517-5601-25,"INJECTION, HYDROXYZINE HCL, UP TO 25 MG",220.2,110.1,21.45,295.12,28
NDC,00517-6710-01,CALCIUM CHLORIDE 10% VIAL,55.07,27.54,13.77,36.35,16
NDC,00517-7604-01,ACETYLCYSTEINE 20% VIAL,54.85,27.42,13.71,36.2,16
NDC,00517-7604-01,"ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM",68.42,34.21,8.15,94.42,56
NDC,00517-9191-01,"INJECTION, AMINOCAPROIC ACID, 1 GRAM",19.0,9.5,2.62,25.84,28
NDC,00536-1047-10,SODIUM BICARB 650 MG TABLET,34.015,17.005,2.88,37.28,16
NDC,00536-1107-88,NICOTINE 14 MG/24HR PATCH,22.965,11.48,3.98,19.8,16
NDC,00536-1247-01,SENEXON-S 50-8.6 MG TABLET,15.765,7.88,3.96,12.04,16
NDC,00536-1995-53,ANTI-DANDRUFF 1% SHAMPOO,29.0,14.5,7.25,19.14,16
NDC,00536-5896-88,NICOTINE 21 MG/24HR PATCH,13.65,6.82,3.41,9.01,16
NDC,00548-5604-00,"INJECTION, ENOXAPARIN SODIUM, 10 MG",10.71,5.36,0.87,14.57,28
NDC,00548-5850-00,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",286.89,143.445,65.1,485.22,31
NDC,00548-5900-00,"INJECTION, COSYNTROPIN, 0.25 MG",233.0,116.5,34.07,404.44,28
NDC,00574-7050-12,BISACODYL 10 MG SUPPOSITORY,10.0,5.0,2.5,6.6,16
NDC,00597-0100-51,SPIRIVA RESPIMAT 2.5 MCG INH,82.06,41.03,20.52,54.16,16
NDC,00603-1542-58,POTASSIUM CL 10% (20 MEQ/15ML),16.1,8.05,4.03,10.63,16
NDC,00641-0367-25,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.25,1.625,0.18,4.24,28
NDC,00641-0410-12,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.24,0.62,0.3,1.68,28
NDC,00641-0476-21,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",85.88,42.94,25.76,116.8,28
NDC,00641-1397-31,"INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG",221.66500000000002,110.83500000000001,39.22,316.88,28
NDC,00641-1410-31,"INJECTION, DIGOXIN, UP TO 0.5 MG",49.83,24.915,12.0,80.55,28
NDC,00641-6008-01,"INJECTION, BUMETANIDE, 0.5 MG",8.36,4.18,0.58,32.8,28
NDC,00641-6020-10,"INJECTION, MORPHINE SULFATE, PRESERVATIVE-FREE FOR EPIDURAL OR INTRATHECAL USE, 10 MG",83.86,41.93,22.28,114.05,28
NDC,00641-6027-01,"INJECTION, FENTANYL CITRATE, 0.1 MG",60.0,30.0,1.96,312.75,56
NDC,00641-6044-01,"INJECTION, LORAZEPAM, 2 MG",141.53,70.765,2.33,295.12,28
NDC,00641-6048-01,"INJECTION, LORAZEPAM, 2 MG",60.0,30.0,2.33,231.1,28
NDC,00641-6061-01,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",68.0,34.0,0.23,92.48,28
NDC,00641-6116-01,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",56.41,28.21,2.19,76.72,28
NDC,00641-6125-01,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",60.0,30.0,3.07,97.73,28
NDC,00641-6127-01,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",119.045,59.525,5.02,308.38,28
NDC,00641-6127-25,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",43.0,21.5,5.02,89.76,28
NDC,00641-6132-01,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",109.95,54.975,0.12,295.12,28
NDC,00641-6137-01,"INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT",33.16,16.58,2.21,45.1,27
NDC,00641-6145-01,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",3.36,3.06,0.18,138.11,28
NDC,00641-6146-01,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",24.56,12.28,0.18,33.4,28
NDC,00641-6149-10,"INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG",3.23,1.62,0.97,4.4,28
NDC,00641-6167-01,"INJECTION, AMIKACIN SULFATE, 100 MG",34.335,17.17,1.02,316.88,28
NDC,00641-6175-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",221.0,110.5,1.09,233.0,28
NDC,00641-6178-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",119.13,59.565,1.09,316.88,28
NDC,00703-0245-01,"INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPECIFIED, 10 MG",12.98,6.49,1.22,219.29,28
NDC,00703-3675-01,"INJECTION, METHOTREXATE SODIUM, 50 MG",37.76,18.88,1.34,292.95,56
NDC,00703-4502-04,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",47.72,23.86,1.78,238.5,28
NDC,00703-5747-11,"INJECTION, CISPLATIN, POWDER OR SOLUTION, 10 MG",43.545,21.77,3.48,93.77,28
NDC,00703-9526-01,"INJECTION, SULFAMETHOXAZOLE 5 MG AND TRIMETHOPRIM 1 MG",2.28,1.14,0.07,3.1,28
NDC,00766-1440-20,NICODERM CQ 7 MG/24HR PATCH,14.93,7.47,3.73,9.86,16
NDC,00781-1061-05,ALPRAZOLAM 0.25 MG TABLET,12.01,6.0,2.5,12.47,16
NDC,00781-2067-05,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",6.87,3.44,0.25,9.35,28
NDC,00781-2322-06,"APREPITANT, ORAL, 5 MG",14.77,7.38,4.43,20.09,28
NDC,00781-2323-06,"APREPITANT, ORAL, 5 MG",15.44,7.72,4.57,21.0,28
NDC,00781-3040-95,REGONOL 10 MG/2 ML AMPUL,158.54,79.27,40.73,134.11,16
NDC,00781-3114-91,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",16.24,8.12,1.8,48.18,56
NDC,00781-3208-85,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",26.82,13.41,0.76,36.47,28
NDC,00781-3209-90,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",26.5,13.25,0.76,36.04,28
NDC,00781-3255-94,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",1.73,0.87,0.74,7.02,27
NDC,00781-3262-04,"INJECTION, ENOXAPARIN SODIUM, 10 MG",223.4,111.7,0.87,308.18,28
NDC,00781-3269-71,EPHEDRINE SULFATE 50 MG/ML VL,171.70499999999998,85.85499999999999,28.34,140.32,16
NDC,00781-3402-78,"INJECTION, AMPICILLIN SODIUM, 500 MG",56.83,28.42,0.97,77.29,28
NDC,00781-3407-78,AMPICILLIN 500 MG VIAL,29.67,14.83,7.42,19.58,16
NDC,00781-3407-78,"INJECTION, AMPICILLIN SODIUM, 500 MG",57.09,28.55,0.97,77.65,28
NDC,00781-3440-71,"INJECTION, COSYNTROPIN, 0.25 MG",154.0,77.0,34.07,209.44,28
NDC,00781-3827-72,"INJECTION, GLYCOPYRROLATE, 0.1 MG",9.055,4.53,0.58,15.62,28
NDC,00781-4063-36,"APREPITANT, ORAL, 5 MG",153.42,76.71,4.57,208.65,28
NDC,00781-6186-67,CIPROFLOX-DEXAMETH OTIC SUSP,284.0,142.0,71.0,187.44,16
NDC,00832-0038-00,OXYBUTYNIN 5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00904-3865-75,DEEP SEA 0.65% NOSE SPRAY,10.0,5.0,2.5,6.6,16
NDC,00904-5854-61,IBUPROFEN 600 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,00904-5921-61,DIGOXIN 125 MCG TABLET,10.0,5.0,2.5,6.6,16
NDC,00904-6082-61,ZOLPIDEM TARTRATE 5 MG TABLET,28.0,14.0,7.0,18.48,16
NDC,00904-6353-61,LEVOFLOXACIN 750 MG TABLET,11.07,5.54,2.77,7.31,16
NDC,00904-6369-61,AMLODIPINE BESYLATE 2.5 MG TAB,10.4,5.2,2.6,21.22,16
NDC,00904-6370-61,AMLODIPINE BESYLATE 5 MG TAB,10.0,5.0,2.5,6.6,16
NDC,00904-6377-61,OLANZAPINE 5 MG TABLET,40.84,20.42,10.21,26.95,16
NDC,00904-6474-61,PANTOPRAZOLE SOD DR 40 MG TAB,58.595,29.3,14.0,40.39,16
NDC,00904-6505-61,MEMANTINE HCL 5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00904-6551-61,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",6.34,3.17,0.02,13.6,28
NDC,00904-6553-04,LINEZOLID 600 MG TABLET,900.75,450.38,225.19,594.5,16
NDC,00904-6565-61,VALACYCLOVIR HCL 500 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,00904-6600-61,PERPHENAZINE 4 MG TABLET,14.0,7.0,3.5,9.24,16
NDC,00904-6773-61,ACETAMINOPHEN 325 MG TABLET,9.41,4.705,1.95,8.16,16
NDC,00904-6808-06,MONTELUKAST SOD 10 MG TABLET,16.18,8.09,3.09,13.2,16
NDC,00904-6830-61,FINASTERIDE 5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,00904-6951-61,LEVOTHYROXINE 75 MCG TABLET,20.0,10.0,5.0,13.2,16
NDC,00904-6991-04,PREGABALIN 25 MG CAPSULE,30.0,15.0,7.5,19.8,16
NDC,00904-7016-61,BUMETANIDE 1 MG TABLET,16.43,8.21,4.11,10.84,16
NDC,00904-7156-61,METRONIDAZOLE 250 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,00904-7178-61,FUROSEMIDE 40 MG TABLET,11.18,5.59,3.0,8.16,16
NDC,00904-7193-61,FAMOTIDINE 20 MG TABLET,15.555,7.78,3.71,12.38,16
NDC,00904-7304-61,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",5.9,2.95,0.48,8.02,28
NDC,00904-7346-61,FLUOXETINE HCL 20 MG CAPSULE,10.0,5.0,2.5,6.6,16
NDC,00904-7725-24,ANTI-DIARRHEAL 2 MG CAPLET,1.03,0.52,0.26,0.68,16
NDC,00904-7914-61,IBUPROFEN 200 MG TABLET,12.36,6.18,3.09,8.16,16
NDC,00941-0424-52,DIANEAL WITH 1.5% DEXTROSE,103.0,51.5,25.75,67.98,16
NDC,00941-0426-52,DIANEAL PD-2 WITH 1.5% DEXT,103.0,51.5,25.75,67.98,16
NDC,00941-0427-52,DIANEAL PD-2 WITH 2.5% DEXT,103.0,51.5,25.75,67.98,16
NDC,00941-0429-52,DIANEAL PD-2 WITH 4.25% DEXT,103.0,51.5,25.75,67.98,16
NDC,00941-0430-52,DIANEAL WITH 2.5% DEXTROSE,103.0,51.5,25.75,67.98,16
NDC,00941-0433-52,DIANEAL WITH 4.25% DEXTROSE,103.0,51.5,25.75,67.98,16
NDC,00944-0493-01,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",355.86,177.93,87.58,490.28,31
NDC,00944-0495-05,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",332.76,166.38,87.58,452.56,31
NDC,00944-2700-02,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",199.05,99.52,59.67,2382.19,31
NDC,00955-1003-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",229.0,114.5,0.87,309.15,28
NDC,00955-1004-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",221.39999999999998,110.69999999999999,0.87,309.63,56
NDC,00955-1010-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",124.455,62.225,0.87,292.95,28
NDC,00955-1015-10,"INJECTION, ENOXAPARIN SODIUM, 10 MG",221.0,110.5,0.87,307.35,28
NDC,00955-1020-01,"INJECTION, DOCETAXEL, 1 MG",70.515,35.255,1.07,131.4,32
NDC,00955-1021-04,"INJECTION, DOCETAXEL, 1 MG",96.03,48.01,1.07,132.38,32
NDC,00990-7935-19,DEXTROSE 20%-WATER IV SOLN,103.0,51.5,25.75,67.98,32
NDC,01000-6700-28,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,10.0,5.0,2.5,6.6,16
NDC,01001-9055-61,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",2.87,1.43,0.35,3.9,28
NDC,01001-9120-01,"INJECTION, ESMOLOL HYDROCHLORIDE, 10 MG",5.88,2.94,0.35,27.2,28
NDC,01001-9925-01,"INJECTION, IFOSFAMIDE, 1 GRAM",291.5,145.75,40.99,396.44,28
NDC,01001-9926-16,"INJECTION, IFOSFAMIDE, 1 GRAM",269.685,134.845,40.99,434.95,28
NDC,01001-9956-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",4.92,2.46,0.97,6.45,27
NDC,01012-2510-01,PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION (NEO-PEDS),3491.66,1745.83,872.92,2304.5,16
NDC,01012-2510-03,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION (NEO-PEDS),5313.25,2656.63,1328.31,3506.75,16
NDC,01012-2620-01,"INJECTION, CANGRELOR, 1 MG",41.2,20.6,12.36,604.48,31
NDC,01045-4710-10,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",39.0,19.5,11.7,604.48,31
NDC,01045-4711-10,"INJECTION, RIMABOTULINUMTOXINB, 100 UNITS",33.35,16.675,8.31,604.48,31
NDC,01051-1300-12,"INSTILLATION, HEXAMINOLEVULINATE HYDROCHLORIDE, 100 MG",3246.0,1623.0,973.8,4414.56,28
NDC,01057-2100-01,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,109.045,54.519999999999996,19.52,87.92,16
NDC,01059-0001-01,"INJECTION, NATALIZUMAB, 1 MG",76.88,38.44,23.06,5897.78,31
NDC,01059-0003-03,HDM FAMOTIDINE 20MG/5ML NS IV SIMPLE DSPN,56.65,28.33,14.16,37.39,16
NDC,01059-0003-06,HDM FOSAPREPITANT 150MG/250ML NS IVPB SIMPLE DSPN,20.595,10.295,5.15,13.6,16
NDC,01059-0003-07,HDM ONDANSETRON 16MG/58ML NS IVPB SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-08,HDM DEXAMETHASONE 4MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-09,HDM DEXAMETHASONE 8MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-10,HDM DEXAMETHASONE 10MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-11,HDM DEXAMETHASONE 12MG/20ML NS SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-12,HDM DEXAMETHASONE 20MG/52ML NS IVPB SIMPLE DSPN,20.6,10.3,5.15,13.6,16
NDC,01059-0003-20,PENTAMIDINE 300 MG SOLUTION FOR INJECTION (FOR OP USE ONLY),281.29,140.64,70.32,185.65,16
NDC,01059-0008-01,HDM IRON SUCROSE 200MG/110ML NS IVPB SIMPLE DSPN,501.945,250.975,19.22,611.82,16
NDC,01059-0008-07,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",8.68,4.34,0.59,250.41,31
NDC,01093-9275-33,ASPIRIN 81 MG CHEWABLE TABLET,10.19,5.09,0.77,6.4,16
NDC,01152-3726-83,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,20.0,10.0,5.0,13.2,16
NDC,01170-1067-23,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,1048.75,524.38,262.19,692.18,16
NDC,01287-0000-11,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,630.885,315.445,6.44,776.21,16
NDC,01310-7001-30,MIRTAZAPINE 7.5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,01353-3800-24,"INJECTION, IMMUNE GLOBULIN, (GAMUNEX-C/GAMMAKED), NON-LYOPHILIZED (E.G., LIQUID), 500 MG",254.24,127.12,76.27,1677.59,31
NDC,01478-9015-05,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,650.03,325.02,162.51,429.02,16
NDC,01478-9250-07,EPHEDRINE 5 MG/ML IV (RSI KIT),83.0,41.5,20.75,54.78,16
NDC,01478-9600-10,"INJECTION, ARSENIC TRIOXIDE, 1 MG",146.47,73.23,4.68,199.19,32
NDC,01478-9900-07,"INJECTION, PROCAINAMIDE HCL, UP TO 1 GM",515.33,257.67,154.6,700.85,27
NDC,01505-4050-01,"INJECTION, ABOBOTULINUMTOXINA, 5 UNITS",29.425,14.715,9.56,604.48,31
NDC,01505-4109-04,"INJECTION, LANREOTIDE, 1 MG",261.45500000000004,130.73000000000002,58.39,5897.78,31
NDC,01505-4112-04,"INJECTION, LANREOTIDE, 1 MG",225.31,112.655,58.39,5897.78,31
NDC,01671-4026-01,"INJECTION, ENOXAPARIN SODIUM, 10 MG",223.32999999999998,111.67,0.87,308.48,56
NDC,01671-4160-01,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",1.42,0.71,0.02,13.6,28
NDC,01671-4576-02,ALLOPURINOL 100 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,01671-4661-02,GABAPENTIN 100 MG CAPSULE,20.0,10.0,5.0,13.2,16
NDC,01671-4813-02,EZETIMIBE 10 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,01671-4889-01,"INJECTION, ERTAPENEM SODIUM, 500 MG",92.79,46.4,15.11,201.38,28
NDC,01672-9019-01,"MYCOPHENOLATE MOFETIL, ORAL, 250 MG",4.29,2.14,0.25,5.83,28
NDC,01672-9114-11,"INJECTION, ETOPOSIDE, 10 MG",17.46,8.73,1.72,24.35,28
NDC,01672-9115-05,"INJECTION, MITOMYCIN, 5 MG",147.04500000000002,73.52000000000001,21.76,389.8,31
NDC,01672-9267-65,"INJECTION, DOCETAXEL, 1 MG",97.34,48.67,1.07,132.38,32
NDC,01723-8900-99,FLUORESCEIN 1 MG EYE STRIPS,10.15,5.08,2.54,6.7,16
NDC,01743-3987-63,DOCUSATE SODIUM 283 MG/5 ML ENEMA,19.0,9.5,4.75,12.54,16
NDC,01865-7117-01,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",119.97,59.98,0.36,316.88,56
NDC,01865-7117-04,"INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT",4.78,2.39,0.59,638.55,56
NDC,02055-5033-00,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",10.0,5.0,2.5,6.6,16
NDC,02315-5240-31,"INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG",57.06,28.53,1.78,77.61,28
NDC,02315-5294-31,"INJECTION, PROCHLORPERAZINE, UP TO 10 MG",30.09,15.04,4.16,78.98,28
NDC,02315-5501-01,HYDROXYZINE HCL 25 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,02315-5547-31,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",8.78,4.39,0.15,227.67,56
NDC,02315-5649-41,"INJECTION, CARMUSTINE, 100 MG",1063.92,531.96,319.18,2382.19,31
NDC,02315-5662-03,CALCITRIOL 0.25 MCG CAPSULE,20.0,10.0,5.0,13.2,16
NDC,02315-5748-41,"PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER 300 MG",334.67499999999995,167.33499999999998,61.41,5911.01,32
NDC,02420-8463-25,LATANOPROST 0.005 % EYE DROPS,649.25,324.63,162.31,428.51,16
NDC,02420-8539-20,ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,148.9,74.45,37.23,98.28,16
NDC,02420-8730-06,PROPARACAINE 0.5 % EYE DROPS,118.755,59.375,26.85,85.88,16
NDC,02420-8735-01,CYCLOPENTOLATE 1 % EYE DROPS,52.13,26.06,13.03,34.41,16
NDC,02502-1101-10,"INJECTION, CEFAZOLIN SODIUM, 500 MG",27.67,13.83,1.37,38.08,84
NDC,02502-1110-20,"INJECTION, CEFOXITIN SODIUM, 1 GM",57.495000000000005,28.744999999999997,7.82,78.88,56
NDC,02502-1121-20,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",37.275,18.64,1.44,108.29,84
NDC,02502-1127-20,"INJECTION, CEFTAZIDIME, PER 500 MG",27.174999999999997,13.585,2.43,62.82,28
NDC,02502-1132-82,"INJECTION, LEVOFLOXACIN, 250 MG",74.96000000000001,37.480000000000004,3.56,103.19,28
NDC,02502-1132-83,"INJECTION, LEVOFLOXACIN, 250 MG",51.35,25.675,3.56,69.63,28
NDC,02502-1143-30,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",33.0,16.5,2.19,44.88,28
NDC,02502-1159-10,"INJECTION, COLISTIMETHATE SODIUM, UP TO 150 MG",118.29,59.14,19.93,160.87,28
NDC,02502-1177-50,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",17.17,8.59,1.8,23.36,28
NDC,02502-1184-82,FLUCONAZOLE IN NACL 2 MG/ML INJECTION (PEDS),155.0,77.5,38.75,102.3,16
NDC,02502-1184-82,"INJECTION FLUCONAZOLE, 200 MG",154.5,77.25,7.39,210.8,56
NDC,02502-1184-87,"INJECTION FLUCONAZOLE, 200 MG",76.14,38.07,7.39,103.55,28
NDC,02502-1185-10,"INJECTION, GANCICLOVIR SODIUM, 500 MG",111.84,55.92,33.55,152.1,28
NDC,02502-1191-10,"INJECTION, MICAFUNGIN SODIUM, 1 MG",1.5899999999999999,0.7949999999999999,0.38,2.79,56
NDC,02502-1204-01,"INJECTION, VINORELBINE TARTRATE, 10 MG",66.66999999999999,33.334999999999994,8.98,90.77,28
NDC,02502-1244-10,"INJECTION, BORTEZOMIB, 0.1 MG",662.95,331.475,4.42,962.55,32
NDC,02502-1305-20,CHLOROTHIAZIDE 25 MG/ML INJECTION,168.76,84.38,42.19,111.38,16
NDC,02502-1305-20,"INJECTION, CHLOROTHIAZIDE SODIUM, PER 500 MG",102.4,51.2,30.72,139.26,28
NDC,02502-1319-05,"INJECTION, DILTIAZEM HYDROCHLORIDE, 0.5 MG",25.18,12.594999999999999,0.05,66.98,28
NDC,02502-1400-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.03,3.02,0.3,8.21,28
NDC,02502-1452-01,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",217.0,108.5,1.09,295.12,28
NDC,02502-1608-20,"INJECTION, PROPOFOL, 10 MG",18.25,9.13,0.15,24.83,28
NDC,02502-1612-81,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",71.2,35.6,0.68,96.83,28
NDC,02502-1673-77,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR (11 ML),24.96,12.48,7.07,16.47,16
NDC,02502-1673-77,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR (CUSTOM),24.495,12.25,5.89,16.79,16
NDC,02502-1801-66,"INJECTION, ZOLEDRONIC ACID, 1 MG",1099.25,549.63,8.38,1643.46,28
NDC,02502-1812-30,"INJECTION, ACETYLCYSTEINE, 100 MG",6.029999999999999,3.0149999999999997,0.61,12.61,28
NDC,02502-1813-10,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",81.32,40.66,6.34,110.59,28
NDC,02502-1814-30,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",47.05,23.53,6.34,63.99,28
NDC,02502-1815-30,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",14.24,7.12,4.27,19.36,28
NDC,02502-1816-30,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",29.055,14.530000000000001,6.34,40.25,28
NDC,02502-1826-82,"INJECTION, ZOLEDRONIC ACID, 1 MG",1269.99,635.0,8.38,1727.19,28
NDC,02568-2001-01,"INJECTION, ECULIZUMAB, 2 MG",183.67000000000002,91.835,39.87,318.82,27
NDC,02568-2025-01,"INJECTION, RAVULIZUMAB-CWVZ, 10 MG",659.61,329.81,197.88,28568.47,31
NDC,02724-1098-03,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",13.33,6.67,3.33,8.8,16
NDC,02930-0128-01,HYDROCHLOROTHIAZIDE 25 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,03172-2204-10,"INJECTION, PANTOPRAZOLE SODIUM, 40 MG",59.23,29.61,4.52,505.24,28
NDC,03172-2730-30,IRBESARTAN 150 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,03333-2025-04,"Influenza vaccine, trivalent, split virus, preservative-free, 0.5 mL dosage",128.32,64.16,20.92,162.0,32
NDC,03600-0320-01,LABETALOL 20 MG/4 ML INTRAVENOUS VIAL/SYRINGE BUNDLED,62.33,31.17,15.58,41.14,16
NDC,03676-5420-19,"MAGNESIUM L-LACTATE ER 84 MG TABLET,EXTENDED RELEASE",11.06,5.53,2.77,7.3,16
NDC,03700-0741-08,PSYLLIUM ORAL PACKET (BUNDLED),20.0,10.0,5.0,13.2,16
NDC,03877-9055-18,SODIUM BENZOATE (BULK) POWDER,23.0,11.5,5.75,15.18,16
NDC,03982-2041-26,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",10.53,5.26,3.16,14.31,28
NDC,03982-2105-55,"INJECTION, AMPHOTERICIN B, 50 MG",150.25,75.13,45.08,204.34,28
NDC,03982-2420-05,ROCURONIUM 10MG/ML INJECTION (PEDS),59.44,29.72,14.86,39.23,16
NDC,04202-3104-01,Skin test for tuberculosis,76.0,38.0,10.2,103.36,32
NDC,04202-3105-01,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,303.0,151.5,75.75,199.98,16
NDC,04202-3116-25,"INJECTION, OXYTOCIN, UP TO 10 UNITS",217.0,108.5,4.44,316.88,28
NDC,04202-3119-25,"INJECTION, TRIMETHOBENZAMIDE HCL, UP TO 200 MG",224.585,112.295,65.79,296.04,28
NDC,04202-3123-06,DANTROLENE 20 MG INTRAVENOUS SOLUTION,186.25,93.13,46.56,122.93,16
NDC,04202-3129-01,"INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG",85.0,42.5,10.23,115.6,28
NDC,04202-3159-01,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",133.945,66.97,0.71,307.21,28
NDC,04202-3159-25,"INJECTION, EPINEPHRINE (ADRENALIN), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",15.695,7.85,2.28,23.38,28
NDC,04202-3164-01,"INJECTION, VASOPRESSIN, 1 UNIT",9.4,4.7,0.87,12.78,28
NDC,04202-3179-01,"INJECTION, BUPRENORPHINE HYDROCHLORIDE, 0.1 MG",28.53,14.26,5.43,295.12,56
NDC,04202-3221-01,"INJECTION, ERTAPENEM SODIUM, 500 MG",133.57,66.79,15.11,232.41,28
NDC,04202-3229-01,"INJECTION, MICAFUNGIN SODIUM, 1 MG",2.12,1.06,0.41,2.88,28
NDC,04202-3237-01,"INJECTION, VASOPRESSIN, 1 UNIT",13.29,6.64,0.87,18.07,28
NDC,04202-3243-01,EPHEDRINE (PF) 5 MG/ML IV - BUNDLED,93.96000000000001,46.985,20.1,70.97,16
NDC,04202-3500-01,EPINEPHRINE 8 MG/250 ML (32 MCG/ML) IV INFUSION FOR ADS,174.1,87.05,43.52,114.9,16
NDC,04236-7521-25,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, (BELRAPZO/BENDAMUSTINE), 1 MG",96.31,39.245,18.2,2382.19,31
NDC,04265-8021-02,"INJECTION, DAUNORUBICIN, 10 MG",307.33,153.67,23.52,759.58,64
NDC,04285-8301-01,HYDROMORPHONE 2 MG TABLET,30.0,15.0,7.5,19.8,16
NDC,04285-8867-06,"DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAG",26.57,13.28,2.23,36.13,28
NDC,04306-6150-10,"INJECTION, AMIODARONE HYDROCHLORIDE (NEXTERONE), 30 MG",31.9,15.95,2.52,43.38,28
NDC,04306-6557-12,DEXMEDETOMIDINE 400 MCG/100 ML NS (4 MCG/ML) IV INFUSION,169.57,84.785,46.12,122.36,16
NDC,04338-6090-19,POLYETHYLENE GLYCOL-ELECTROLYTE (GOLYTELY) SOLUTION (PEDS),82.0,41.0,20.5,54.12,16
NDC,04354-7270-10,ROPINIROLE 1 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,04354-7399-10,CYCLOBENZAPRINE 5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,04354-7544-01,"INJECTION, GLYCOPYRROLATE, 0.1 MG",37.89,18.95,0.58,51.54,28
NDC,04359-8848-11,"INJECTION, ZIPRASIDONE MESYLATE, 10 MG",133.815,66.91,15.1,295.12,28
NDC,04382-5200-01,TERLIPRESSIN 0.85 MG INTRAVENOUS POWDER FOR SOLUTION,2159.81,1079.9,539.95,1425.47,16
NDC,04408-7353-51,"INJECTION, AVELUMAB, 10 MG",278.84,139.42,83.65,5897.78,31
NDC,04420-6310-50,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",343.51,171.75,87.58,467.17,31
NDC,04420-6436-05,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",249.005,124.505,61.58,161.84,16
NDC,04420-6436-90,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",219.5,109.75,65.85,1677.59,62
NDC,04420-6437-91,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",233.355,116.675,62.7,1677.59,62
NDC,04420-6438-92,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",203.32,101.66,60.87,1677.59,62
NDC,04420-6439-93,"INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",201.1,100.55,60.33,1677.59,62
NDC,04456-7241-10,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.18,15.59,1.44,100.58,56
NDC,04456-7620-01,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",1.52,0.76,0.05,2.07,28
NDC,04580-2098-51,MESALAMINE 4 GRAM/60 ML ENEMA,55.0,27.5,13.75,36.3,16
NDC,04580-2465-64,KETOCONAZOLE 2 % SHAMPOO,61.0,30.5,15.25,40.26,16
NDC,04580-2730-00,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,11.11,5.56,2.78,7.33,16
NDC,04596-3709-11,"METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",10.0,5.0,2.5,6.6,16
NDC,04596-3733-68,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",100.61500000000001,50.31,4.59,175.87,56
NDC,04628-7006-60,SODIUM POLYSTYRENE SULFONATE 15 G/60 ML ORAL SUSP (BUNDLED ERX),73.85,36.93,18.46,48.74,16
NDC,04628-7009-01,ISONIAZID 10MG/ML ORAL SOLUTION OR SYRUP  (PEDS),3.57,1.79,0.89,2.36,16
NDC,04628-7500-30,SORBITOL 70 % SOLUTION,19.93,9.96,4.98,13.15,16
NDC,04733-5049-40,"INJECTION, DOXORUBICIN HYDROCHLORIDE, LIPOSOMAL, NOT OTHERWISE SPECIFIED, 10 MG",2049.68,1024.84,120.64,2787.56,31
NDC,04733-5931-44,UNCLASSIFIED DRUGS,64.29,32.14,19.29,87.43,26
NDC,04733-5936-40,"LEUPROLIDE ACETATE, PER 1 MG",333.245,166.625,43.27,710.29,28
NDC,04742-6401-01,"INJECTION, APREPITANT (APONVIE), 1 MG",7.16,3.58,2.91,9.74,20
NDC,04778-1426-11,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,128.57,64.285,8.03,148.5,16
NDC,04928-1547-58,"Haemophilus influenzae type b vaccine, PRP-T conjugate",122.15,61.07,26.68,178.23,64
NDC,04928-1574-88,"Respiratory syncytial virus antibody, 1.0 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
NDC,04928-1575-00,"Respiratory syncytial virus antibody, 0.5 mL dosage for injection into muscle",1165.0,582.5,349.5,1584.4,32
NDC,04928-1860-78,Poliovirus vaccine,124.83,62.42,26.68,218.47,32
NDC,04934-8274-72,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",12.36,6.18,3.09,8.16,16
NDC,04940-1101-01,"INJECTION, BELIMUMAB, 10 MG",115.1,57.55,34.53,1677.59,31
NDC,04940-1102-01,"INJECTION, BELIMUMAB, 10 MG",137.51,68.75,41.25,1677.59,31
NDC,04947-1001-05,BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL INJECTION SOLUTION,386.0,193.0,96.5,254.76,16
NDC,04950-2500-01,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",218.91,109.46,0.71,314.55,28
NDC,04959-1052-11,Hepatitis B immune globulin for injection into muscle,878.0,439.0,227.42,1286.64,31
NDC,04977-1002-01,"INJECTION, MITOMYCIN, 5 MG",1120.5,560.25,43.07,1523.88,31
NDC,05019-0141-23,SODIUM CHLORIDE 7 % FOR NEBULIZATION,11.92,5.96,3.11,7.52,16
NDC,05024-2009-01,"INJECTION, TENECTEPLASE, 1 MG",552.54,276.27,165.76,5897.78,31
NDC,05024-2037-06,"INJECTION, TENECTEPLASE, 1 MG",613.98,306.99,184.2,5897.78,31
NDC,05024-2041-64,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",494.28999999999996,247.14499999999998,121.68,769.76,93
NDC,05024-2044-06,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",416.94,208.47,121.68,567.04,31
NDC,05024-2051-21,"INJECTION, RITUXIMAB, 10 MG",272.405,136.2,81.76,4737.06,31
NDC,05024-2060-01,"INJECTION, BEVACIZUMAB, 10 MG",423.0,211.5,98.06,2382.19,62
NDC,05024-2070-01,"INJECTION, OBINUTUZUMAB, 10 MG",190.55,95.28,57.17,5897.78,31
NDC,05024-2077-01,"INJECTION, TRASTUZUMAB, 10 MG AND HYALURONIDASE-OYSK",388.745,194.375,92.46,4737.06,31
NDC,05024-2087-01,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",143.17,71.59,42.95,4737.06,31
NDC,05024-2088-01,"INJECTION, ADO-TRASTUZUMAB EMTANSINE, 1 MG",143.17,71.59,42.95,4737.06,31
NDC,05024-2100-40,"DORNASE ALFA, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",116.7,58.35,35.01,158.71,32
NDC,05024-2103-01,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",413.18,206.59,123.95,9401.8,31
NDC,05024-2105-01,"INJECTION, POLATUZUMAB VEDOTIN-PIIQ, 1 MG",398.055,199.02499999999998,119.65,9401.8,31
NDC,05024-2125-01,"INJECTION, GLOFITAMAB-GXBM, 2.5 MG",11069.725,5534.865,3799.94,17226.38,27
NDC,05024-2132-01,"INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG",362.45,181.23,108.74,2382.19,31
NDC,05024-2135-01,"INJECTION, TOCILIZUMAB, 1 MG",12.4,6.2,3.72,1286.64,31
NDC,05024-2136-01,"INJECTION, TOCILIZUMAB, 1 MG",33.19,16.59,9.26,1286.64,31
NDC,05024-2137-01,"INJECTION, TOCILIZUMAB, 1 MG",34.85,17.42,9.26,1286.64,31
NDC,05024-2145-01,"INJECTION, PERTUZUMAB, 1 MG",40.735,20.365000000000002,9.97,4737.06,31
NDC,05024-2150-01,"INJECTION, OCRELIZUMAB, 1 MG",202.42,101.21,40.56,28568.47,31
NDC,05024-2245-01,"INJECTION, PERTUZUMAB, TRASTUZUMAB, AND HYALURONIDASE-ZZXF, PER 10 MG",487.38,243.69,78.53,4737.06,31
NDC,05024-2260-01,"INJECTION, PERTUZUMAB, TRASTUZUMAB, AND HYALURONIDASE-ZZXF, PER 10 MG",643.29,321.64,78.53,4737.06,31
NDC,05024-2917-01,"INJECTION, ATEZOLIZUMAB, 10 MG",335.53499999999997,167.77,66.13,9401.8,31
NDC,05024-2918-01,"INJECTION, ATEZOLIZUMAB, 10 MG",221.92000000000002,110.96000000000001,66.56,9401.8,31
NDC,05026-8130-11,BUMETANIDE 0.5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05026-8337-11,FLUCONAZOLE 100 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05026-8489-11,LORATADINE 10 MG TABLET,20.0,10.0,4.53,37.8,16
NDC,05026-8684-15,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",12.190000000000001,6.09,1.29,15.51,28
NDC,05026-8710-11,ROSUVASTATIN 20 MG TABLET,58.0,29.0,14.5,38.28,16
NDC,05026-8851-11,THIAMINE 100 MG TABLET (BUNDLED ERX),20.0,10.0,5.0,13.2,16
NDC,05041-9320-01,"INJECTION, GADOXETATE DISODIUM, 1 ML",48.83,24.41,14.65,66.41,56
NDC,05041-9423-01,"LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG",2516.0,1258.0,570.27,3421.76,32
NDC,05045-8563-01,"INJECTION, PALIPERIDONE PALMITATE EXTENDED RELEASE (ERZOFRI), 1 MG",56.05,28.02,0.56,75.66,27
NDC,05045-8596-01,RISPERIDONE 1 MG/ML SYRUP (PEDS),24.0,12.0,6.0,15.84,16
NDC,05047-4700-62,"INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",42.89,21.44,6.39,1677.59,31
NDC,05047-4970-63,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,45.42,22.71,11.35,29.98,16
NDC,05063-2010-01,Rabies vaccine for injection into muscle,463.15500000000003,231.575,34.8,1823.64,31
NDC,05063-3210-11,"INJECTION, GLUCARPIDASE, 10 UNITS",1065.77,532.88,319.73,20978.86,31
NDC,05074-2118-08,"CABERGOLINE, ORAL, 0.25 MG",6.76,3.38,2.03,30.24,28
NDC,05074-2261-01,NIFEDIPINE EXTENDED RELEASE 60 MG TAB (BUNDLED ERX),20.0,10.0,5.0,13.2,16
NDC,05074-2505-01,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,44.55,22.275,6.67,35.33,16
NDC,05074-2505-01,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH (PERIOPERATIVE USE),27.0,13.5,6.75,17.82,16
NDC,05088-1023-11,"INJECTION, AXATILIMAB-CSFR, 0.1 MG",267.16,133.58,80.15,363.34,27
NDC,05107-9074-01,HYDRALAZINE 10 MG TABLET,10.055,5.029999999999999,2.5,6.6,16
NDC,05107-9075-01,HYDRALAZINE 25 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,05107-9170-01,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",10.0,5.0,2.5,6.6,16
NDC,05107-9255-20,METOPROLOL TARTRATE 25 MG TABLET,8.68,4.34,1.25,7.64,16
NDC,05107-9285-01,DIAZEPAM 5 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05107-9453-01,MIDODRINE 5 MG TABLET,5.96,2.98,1.49,3.93,16
NDC,05107-9597-20,CETIRIZINE 10 MG TABLET,15.24,7.62,2.62,13.2,16
NDC,05107-9670-01,"METHOTREXATE; ORAL, 2.5 MG",20.31,10.16,0.25,27.62,28
NDC,05107-9684-20,ATENOLOL 50 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,05107-9690-01,LOPERAMIDE 2 MG CAPSULE,11.35,5.675,0.68,13.2,16
NDC,05107-9801-20,METOPROLOL TARTRATE 50 MG TABLET,8.85,4.425,1.92,6.6,16
NDC,05107-9980-01,SPIRONOLACTONE 100 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05114-4003-01,"INJECTION, TISOTUMAB VEDOTIN-TFTV, 1 MG",544.75,272.37,160.27,20978.86,31
NDC,05114-4020-01,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",88.465,44.230000000000004,23.74,5897.78,31
NDC,05114-4030-01,"INJECTION, ENFORTUMAB VEDOTIN-EJFV, 0.25 MG",101.57,50.785,29.34,5897.78,31
NDC,05114-4050-01,"INJECTION, BRENTUXIMAB VEDOTIN, 1 MG",616.525,308.265,108.93,9401.8,31
NDC,05155-2005-53,ACETIC ACID (BULK) 5 % LIQUID,31.7,15.85,7.93,20.92,16
NDC,05167-2212-02,"NEOMYCIN-BACITRACN ZN-POLYMYX 3.5 MG-400 UNIT-5,000 UNIT/GRAM TOP OINT",20.0,10.0,5.0,13.2,16
NDC,05175-4020-31,UNCLASSIFIED DRUGS,125.36,62.68,37.61,170.5,26
NDC,05199-1014-06,MELATONIN 3 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05374-6642-01,FLECAINIDE 100 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05428-8103-01,"INJECTION, EPINEPHRINE (BPI), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",123.28999999999999,61.644999999999996,1.08,316.88,84
NDC,05428-8105-15,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,2524.33,1262.165,772.11,1939.55,16
NDC,05428-8120-01,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",7.35,3.67,0.71,9.99,28
NDC,05428-8136-01,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",55.38,27.69,16.61,75.32,28
NDC,05428-8142-01,"INJECTION, PAPAVERINE HCL, UP TO 60 MG",71.01,35.5,21.3,96.57,28
NDC,05448-2147-01,"INJECTION, LEVOCARNITINE, PER 1 GM",74.375,37.19,15.84,130.48,56
NDC,05483-8502-80,HYDROXYZINE 10 MG/5 ML SYRUP (PEDS),2.82,1.41,0.7,1.86,16
NDC,05483-8502-80,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,5.55,2.78,1.39,3.67,16
NDC,05511-1556-10,"INJECTION, DECITABINE, 1 MG",11.27,5.635,1.07,187.7,32
NDC,05511-1688-52,"INJECTION, ZOLEDRONIC ACID, 1 MG",222.48,111.24,8.38,1000.0,28
NDC,05513-5132-01,"INJECTION, SACITUZUMAB GOVITECAN-HZIY, 2.5 MG",103.63499999999999,51.815,31.09,1228.64,31
NDC,05515-0113-10,"INJECTION, AMPICILLIN SODIUM, 500 MG",28.9,14.45,0.97,39.98,56
NDC,05515-0114-20,"INJECTION, AMPICILLIN SODIUM, 500 MG",15.54,7.77,0.97,25.72,56
NDC,05515-0116-20,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",58.35,29.175,2.19,81.65,56
NDC,05515-0117-20,"INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM",32.04,16.02,2.19,65.36,28
NDC,05515-0128-24,"INJECTION, OXACILLIN SODIUM, UP TO 250 MG",9.65,4.83,0.94,13.13,28
NDC,05515-0155-21,"INJECTION, ACYCLOVIR, 5 MG",1.5,0.75,0.2,2.04,28
NDC,05515-0173-01,"INJECTION, SUMATRIPTAN SUCCINATE, 6 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED)",226.935,113.47,69.21,314.55,28
NDC,05515-0188-10,TRANEXAMIC ACID (CYKLOKAPRON) 100 MG/ML INHALATION SOLUTION,60.97,30.48,15.24,40.24,16
NDC,05515-0188-10,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",53.71,26.85,13.43,35.45,16
NDC,05515-0188-10,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV (FOR L+D ORDER SET ONLY)",61.77,30.88,15.44,40.77,16
NDC,05515-0188-10,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV (OR USE)",61.38,30.69,15.34,40.51,16
NDC,05515-0188-10,TRANEXAMIC ACID 100 MG/ML IV (PEDS),61.0,30.5,15.25,40.26,16
NDC,05515-0219-10,"INJECTION, EPTIFIBATIDE, 5 MG",26.62,13.31,5.81,47.67,31
NDC,05515-0230-00,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",217.0,108.5,1.45,316.88,28
NDC,05515-0232-00,"INJECTION, FONDAPARINUX SODIUM, 0.5 MG",7.4,3.7,1.45,10.06,28
NDC,05515-0241-01,"INJECTION, ARGATROBAN (AUROMEDICS), NOT THERAPEUTICALLY EQUIVALENT TO J0883, 1 MG (FOR NON-ESRD USE)",2.02,1.01,0.61,128.98,32
NDC,05515-0330-01,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SYRINGE,224.29,112.14,0.71,164.76,16
NDC,05515-0437-01,"INJECTION, DEXRAZOXANE HYDROCHLORIDE, PER 250 MG",866.72,433.36,95.72,1195.91,31
NDC,05529-2702-54,"INJECTION, HEMIN, 1 MG",79.47999999999999,39.74,22.98,4737.06,31
NDC,05551-3005-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",222.55,111.28,4.98,604.48,31
NDC,05551-3028-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",224.60000000000002,112.305,4.98,604.48,31
NDC,05551-3032-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",122.59,61.295,4.98,604.48,31
NDC,05551-3069-01,"INJECTION, TARLATAMAB-DLLE, 1 MG",5859.0,2929.5,1668.6,8310.6,27
NDC,05551-3078-01,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",168.92,84.46,50.68,5897.78,31
NDC,05551-3079-01,"INJECTION, TALIMOGENE LAHERPAREPVEC, PER 1 MILLION PLAQUE FORMING UNITS",275.66,137.83,82.7,5897.78,31
NDC,05551-3103-01,"INJECTION, TARLATAMAB-DLLE, 1 MG",7500.0,3750.0,2250.0,10200.0,27
NDC,05551-3111-01,"INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)",225.45499999999998,112.72999999999999,4.98,604.48,31
NDC,05551-3112-01,"INJECTION, TEZEPELUMAB-EKKO, 1 MG",116.56,58.28,2.96,2382.19,31
NDC,05551-3132-01,"INJECTION, TRASTUZUMAB-ANNS, BIOSIMILAR, (KANJINTI), 10 MG",366.57,183.28,84.88,1677.59,31
NDC,05551-3150-01,"INJECTION, BLINATUMOMAB, 1 MICROGRAM",722.55,361.27,216.76,5897.78,31
NDC,05551-3190-01,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",225.39499999999998,112.695,67.77,2382.19,31
NDC,05551-3192-01,"INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG",326.125,163.065,91.35,2382.19,31
NDC,05551-3207-01,"INJECTION, BEVACIZUMAB-AWWB, BIOSIMILAR, (MVASI), 10 MG",251.18,125.59,39.34,1286.64,31
NDC,05551-3209-91,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",111.155,55.575,1.24,295.12,31
NDC,05551-3221-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",219.72,109.86,10.55,298.82,27
NDC,05551-3222-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",25.95,12.97,7.72,298.35,27
NDC,05551-3223-01,"INJECTION, ROMIPLOSTIM, 1 MICROGRAM",126.16499999999999,63.084999999999994,7.82,308.95,27
NDC,05551-3670-01,"INJECTION, INFLIXIMAB-AXXQ, BIOSIMILAR, (AVSOLA), 10 MG",220.235,110.11500000000001,39.29,604.48,31
NDC,05551-3710-01,"INJECTION, DENOSUMAB, 1 MG",105.975,52.989999999999995,22.93,1228.64,31
NDC,05551-3730-01,"INJECTION, DENOSUMAB, 1 MG",642.98,321.49,13.02,1228.64,31
NDC,05551-3880-01,"INJECTION, ROMOSOZUMAB-AQQG, 1 MG",88.42,44.21,19.51,1286.64,31
NDC,05551-3924-01,"INJECTION, FILGRASTIM (G-CSF), EXCLUDES BIOSIMILARS, 1 MICROGRAM",5.32,2.66,1.24,306.0,31
NDC,05551-3954-01,"INJECTION, PANITUMUMAB, 10 MG",544.06,272.03,163.36,4737.06,31
NDC,05556-6105-00,"INTRAVESICAL INSTILLATION, NADOFARAGENE FIRADENOVEC-VNCG, PER THERAPEUTIC DOSE",144843.75,72421.88,26951.36,196987.5,31
NDC,05556-6280-00,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",2696.0,1348.0,674.0,1779.36,16
NDC,05556-6830-31,"INJECTION, DEGARELIX, 1 MG",272.375,136.19,7.34,705.84,31
NDC,05556-6840-20,"INJECTION, DEGARELIX, 1 MG",30.35,15.18,7.34,389.8,31
NDC,05723-7077-10,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",8.75,4.38,0.02,23.42,28
NDC,05789-4030-01,"INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG",235.18,117.59,53.49,1286.64,124
NDC,05789-4054-27,"USTEKINUMAB, FOR INTRAVENOUS INJECTION, 1 MG",70.175,35.09,14.6,4737.06,31
NDC,05789-4061-03,"USTEKINUMAB, FOR SUBCUTANEOUS INJECTION, 1 MG",12.62,6.31,3.79,9401.8,32
NDC,05789-4350-01,"INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE",98.385,49.190000000000005,15.51,1677.59,31
NDC,05789-4449-01,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",109.39,54.69,34.96,4737.06,31
NDC,05789-4450-01,"INJECTION, TECLISTAMAB-CQYV, 0.5 MG",340.2,285.0,35.0,4737.06,31
NDC,05789-4469-01,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",161.44,80.72,19.7,969.68,27
NDC,05789-4470-01,"INJECTION, TALQUETAMAB-TGVS, 0.25 MG",230.395,33.34,20.0,659.91,27
NDC,05789-4501-00,"INJECTION, AMIVANTAMAB-VMJW, 2 MG",74.25,37.125,18.46,5897.78,31
NDC,05789-4503-01,"INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ",645.375,322.685,49.93,4737.06,31
NDC,05789-4650-01,"INJECTION, GUSELKUMAB, 1 MG",257.2,128.6,77.16,9401.8,31
NDC,05816-0723-03,"Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use",589.38,294.695,26.68,1433.19,32
NDC,05816-0810-52,"Diphtheria, tetanus, and acellular pertussis vaccine (younger than 7 years)",104.36,52.18,26.62,128.16,32
NDC,05816-0811-52,"Diphtheria, tetanus, acellular pertussis, hepatitis B, and polio vaccine",215.17,107.58,26.68,316.88,32
NDC,05816-0820-43,"Hepatitis B vaccine, pediatric or adolescent dosage (3 dose schedule)",183.0,91.5,26.68,316.88,32
NDC,05816-0821-52,"Hepatitis B vaccine, adult dosage (3 dose schedule)",125.695,62.85,26.68,211.3,32
NDC,05816-0823-11,Shingles vaccine for injection into muscle,416.855,208.43,38.9,962.65,30
NDC,05816-0842-43,"Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)",132.08499999999998,66.03999999999999,26.68,428.4,32
NDC,05816-0958-01,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",149.0,74.5,36.0,860.63,32
NDC,05816-0959-01,"Meningococcal vaccine, serogroups A, C, W, Y, diphtheria toxoid carrier vaccine",173.995,87.0,36.0,349.64,32
NDC,05816-0976-20,"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B",713.625,356.815,38.9,7389.48,32
NDC,05846-8003-01,"INJECTION, THYROTROPIN ALPHA, 0.9 MG, PROVIDED IN 1.1 MG VIAL",5151.63,2575.815,118.83,20244.71,31
NDC,05846-8004-01,"INJECTION, AGALSIDASE BETA, 1 MG",502.64,251.32,150.79,9401.8,31
NDC,05846-8004-11,"INJECTION, AGALSIDASE BETA, 1 MG",502.64,251.32,150.79,9401.8,31
NDC,05846-8008-01,"LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCYTE GLOBULIN, RABBIT, PARENTERAL, 25 MG",5113.725,2556.8599999999997,1504.0,7091.2,62
NDC,05846-8009-03,"HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR INJECTION, 1 MG",104.025,52.015,12.47,250.41,31
NDC,05846-8042-61,"INJECTION, AVALGLUCOSIDASE ALFA-NGPT, 4 MG",65.17,32.59,19.55,28568.47,31
NDC,05846-8466-31,"INJECTION, IMIGLUCERASE, 10 UNITS",147.01,73.5,44.1,9401.8,31
NDC,05891-4171-10,SUCRALFATE 1 GRAM TABLET,20.0,10.0,5.0,13.2,16
NDC,05901-1410-20,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",28.88,14.44,7.22,19.06,16
NDC,05901-1420-20,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",12.36,6.18,3.09,8.16,16
NDC,05901-1750-04,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,161.76,80.88,40.44,106.76,16
NDC,05901-1752-04,BUPRENORPHINE 20 MCG/HOUR WEEKLY TRANSDERMAL PATCH,290.34,145.17,72.58,191.62,16
NDC,05914-8007-13,ARIPIPRAZOLE 5 MG TABLET,228.58,114.29,57.15,150.87,16
NDC,05933-8775-01,"INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (NON-ESRD USE)",8.67,2.925,0.59,250.41,31
NDC,05936-5512-81,INTRAUTERINE COPPER CONTRACEPTIVE (PARAGARD),2754.76,1377.38,121.68,4841.6,32
NDC,05938-5022-01,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,37.93,18.96,9.48,25.03,16
NDC,05938-5023-01,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,43.75,21.87,10.94,28.87,16
NDC,05957-2102-01,"INJECTION, AZACITIDINE, 1 MG",5.2,2.6,0.76,1207.95,64
NDC,05957-2711-01,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",227.745,113.875,33.04,9401.8,31
NDC,05957-2775-01,"INJECTION, LUSPATERCEPT-AAMT, 0.25 MG",226.33,114.0,38.28,9401.8,31
NDC,05957-2962-10,"INJECTION, ROMIDEPSIN, LYOPHILIZED, 0.1 MG",117.53,58.76,35.26,5897.78,31
NDC,05963-0266-01,"INJECTION, CEFIDEROCOL, 10 MG",5.26,2.63,1.58,154.11,31
NDC,05967-6310-01,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",145.65,72.83,12.77,310.95,31
NDC,05967-6340-01,"INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS",146.06,73.03,6.85,360.55,31
NDC,05967-6610-01,"INJECTION, TRABECTEDIN, 0.1 MG",1269.005,634.5,362.75,5897.78,32
NDC,05967-6820-01,"HYALURONAN OR DERIVATIVE, MONOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE",4236.86,2118.43,570.27,5762.12,31
NDC,05974-6115-06,"PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 4",5.49,3.085,1.29,13.6,28
NDC,05976-2007-41,HYDROCORTISONE 10 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,05976-2120-54,"SIROLIMUS, ORAL, 1 MG",46.68,23.34,1.6,63.49,28
NDC,05976-2330-41,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,45.26,22.63,11.32,29.87,16
NDC,05976-2444-03,"METHYLPREDNISOLONE ORAL, PER 4 MG",12.96,6.48,0.23,17.63,28
NDC,06021-9107-61,"AZATHIOPRINE, ORAL, 50 MG",14.305,7.15,0.1,27.2,28
NDC,06021-9234-81,TRAMADOL 50 MG TABLET,30.0,15.0,7.5,19.8,16
NDC,06026-7705-50,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,6.695,3.3449999999999998,1.69,4.37,16
NDC,06050-5074-91,"INJECTION, CEFAZOLIN SODIUM, 500 MG",56.0,28.0,1.37,76.16,28
NDC,06050-5082-91,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",521.0,260.5,130.25,343.86,16
NDC,06050-5614-25,"INJECTION, CEFAZOLIN SODIUM, 500 MG",27.22,13.61,1.37,37.02,28
NDC,06050-5614-40,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",31.41,15.71,1.44,42.72,28
NDC,06050-5614-70,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",18.48,9.24,1.44,25.13,28
NDC,06050-5619-31,"INJECTION, PALONOSETRON HCL, 25 MCG",38.9,19.45,0.58,52.9,28
NDC,06068-7155-11,METFORMIN 500 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,06068-7195-11,DILTIAZEM CD 120 MG 24 HR CAP (BUNDLED),13.33,6.67,3.33,8.8,16
NDC,06068-7217-11,DILTIAZEM CD 240 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
NDC,06068-7228-11,DILTIAZEM CD 300 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
NDC,06068-7369-01,DICYCLOMINE 10 MG CAPSULE,10.0,5.0,2.5,6.6,16
NDC,06068-7405-79,"ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME",12.07,6.03,0.33,27.2,28
NDC,06068-7436-11,CELECOXIB 100 MG CAPSULE,49.0,24.5,12.25,32.34,16
NDC,06068-7454-11,TRAZODONE 100 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06068-7576-40,MIDAZOLAM 2MG/ML SOLUTION (PEDS),36.38,18.19,9.09,24.01,16
NDC,06068-7591-11,GABAPENTIN 300 MG CAPSULE,14.89,7.45,3.72,9.83,16
NDC,06068-7614-11,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06068-7620-11,METOCLOPRAMIDE 5 MG TABLET,12.36,6.18,3.09,8.16,16
NDC,06068-7631-11,METOCLOPRAMIDE 10 MG TABLET,12.36,6.18,3.09,8.16,16
NDC,06068-7681-11,FOLIC ACID 1 MG TABLET,11.76,5.88,2.94,7.76,16
NDC,06068-7717-11,DILTIAZEM 30 MG TABLET,16.18,8.09,3.71,12.56,16
NDC,06068-7742-11,AZITHROMYCIN 250 MG TABLET,357.0,178.5,89.25,235.62,16
NDC,06068-7753-11,AZITHROMYCIN 500 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06079-3215-05,"THROMBIN (BOVINE) 5,000 UNIT TOPICAL SOLUTION",121.03,60.52,30.26,79.88,16
NDC,06079-3701-02,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",112.155,56.08,7.07,295.12,62
NDC,06079-3702-04,"INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS",72.68,36.34,19.41,314.55,31
NDC,06131-4318-05,"INJECTION, FILGRASTIM-SNDZ, BIOSIMILAR, (ZARXIO), 1 MICROGRAM",5.42,2.705,0.58,316.88,31
NDC,06131-4354-01,TROPICAMIDE 0.5 % EYE DROPS,84.83,42.415,20.67,57.42,16
NDC,06131-4355-02,TROPICAMIDE 1 % EYE DROPS,37.63,18.82,9.41,24.84,16
NDC,06155-3413-41,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",37.31,18.65,0.68,51.0,28
NDC,06157-0131-40,SILVER SULFADIAZINE 1 % TOPICAL CREAM,35.0,17.5,8.75,23.1,16
NDC,06170-3304-36,"INJECTION, CYTARABINE, 100 MG",570.0,285.0,1.39,969.68,28
NDC,06170-3305-38,"INJECTION, CYTARABINE, 100 MG",600.8299999999999,300.41499999999996,1.39,859.06,28
NDC,06170-3309-16,"VINCRISTINE SULFATE, 1 MG",66.03,33.015,13.45,248.32,28
NDC,06170-3319-22,"INJECTION, CYTARABINE, 100 MG",570.0,285.0,1.39,1035.0,28
NDC,06170-3323-22,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",1506.51,753.255,37.98,2885.16,28
NDC,06170-3326-18,"INJECTION, PAMIDRONATE DISODIUM, PER 30 MG",58.44,29.22,17.53,79.48,28
NDC,06170-3332-18,"INJECTION, BLEOMYCIN SULFATE, 15 UNITS",540.0450000000001,270.02,37.98,1274.24,28
NDC,06170-3339-56,"INJECTION, CARBOPLATIN, 50 MG",72.86,36.43,4.83,236.03,28
NDC,06170-3342-50,"INJECTION, PACLITAXEL, 1 MG",11.18,5.59,0.17,15.85,28
NDC,06170-3343-18,"INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG",152.36,76.18,45.71,207.21,31
NDC,06170-3349-09,"INJECTION, IRINOTECAN, 20 MG",33.28,16.64,2.95,56.13,28
NDC,06170-3363-18,"INJECTION, OXALIPLATIN, 0.5 MG",71.125,35.56,0.08,97.03,28
NDC,06175-5008-01,"INJECTION, CEMIPLIMAB-RWLC, 1 MG",89.78,44.89,28.25,5897.78,31
NDC,06195-8290-12,"INJECTION, REMDESIVIR, 1 MG",14.07,7.035,4.21,604.48,31
NDC,06195-9001-01,LIDOCAINE 5 % TOPICAL PATCH,80.0,40.0,20.0,52.8,16
NDC,06275-6518-88,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06275-6529-40,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",46.37,23.18,4.95,298.84,64
NDC,06275-6827-40,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",19.25,9.62,3.97,43.44,28
NDC,06285-6215-01,"INJECTION, LECANEMAB-IRMB, 1 MG",4.75,2.38,1.43,736.42,31
NDC,06285-6389-01,"INJECTION, ERIBULIN MESYLATE, 0.1 MG",318.0,159.0,96.25,1677.59,31
NDC,06293-5223-05,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",573.57,286.52,233.44,2277.82,31
NDC,06293-5305-29,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",580.0,290.0,183.28,1775.36,31
NDC,06293-5453-45,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",980.365,490.18500000000006,281.79,1892.54,31
NDC,06293-5753-75,"LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG",1353.435,676.72,281.79,2277.82,31
NDC,06330-4719-90,DILTIAZEM CD 180 MG 24 HR CAP (BUNDLED),20.0,10.0,5.0,13.2,16
NDC,06332-3010-01,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",46.004999999999995,23.005000000000003,3.58,78.33,28
NDC,06332-3010-03,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",73.87,36.93,3.58,312.53,28
NDC,06332-3030-11,"CHORIONIC GONADOTROPIN, HUMAN 10,000 UNIT IM POWDER FOR SOLUTION",170.64,85.32,32.48,153.78,16
NDC,06332-3064-01,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",14.75,7.38,0.68,20.06,28
NDC,06332-3064-02,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",6.895,3.45,0.68,14.3,28
NDC,06332-3064-10,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",24.69,12.35,0.68,33.58,28
NDC,06332-3083-05,SODIUM BICARBONATE 0.5MEQ/ML INJECTION (NEO),73.73,36.87,18.43,48.66,16
NDC,06332-3086-50,POTASSIUM PHOSPHATE 4.4 MEQ/ML (CRRT) INJECTION (NEO),96.0,48.0,24.0,63.36,16
NDC,06332-3086-50,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,99.14500000000001,49.57,22.74,74.73,16
NDC,06332-3086-50,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION (NEO),89.12,44.56,22.28,58.82,16
NDC,06332-3089-50,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.825,26.415,8.32,142.13,16
NDC,06332-3093-01,SODIUM CHLORIDE 4 MEQ/ML INJECTION (NEO),46.74,23.37,11.68,30.85,16
NDC,06332-3107-01,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",332.69,166.35,0.68,872.44,28
NDC,06332-3117-10,"INJECTION, FLUOROURACIL, 500 MG",35.82,17.91,3.2,173.81,56
NDC,06332-3117-19,"INJECTION, FLUOROURACIL, 500 MG",12.02,6.01,3.2,16.34,28
NDC,06332-3117-20,"INJECTION, FLUOROURACIL, 500 MG",42.75,21.37,3.2,86.12,28
NDC,06332-3123-10,"INJECTION, METHOTREXATE SODIUM, 50 MG",29.485,14.745000000000001,4.26,40.25,28
NDC,06332-3128-20,"DACARBAZINE, 100 MG",64.17500000000001,32.085,6.8,86.56,28
NDC,06332-3140-10,"INJECTION, CLADRIBINE, PER 1 MG",126.74,63.37,12.24,250.36,31
NDC,06332-3161-00,"INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG",136.475,68.24,0.54,316.88,54
NDC,06332-3180-01,"INJECTION, PYRIDOXINE HCL, 100 MG",78.0,39.0,23.07,292.95,56
NDC,06332-3184-11,"INJECTION, FOLIC ACID, 0.1 MG",223.0,111.5,0.08,303.75,28
NDC,06332-3192-02,"INJECTION, FLUDARABINE PHOSPHATE, 50 MG",402.28,201.14,120.68,547.09,28
NDC,06332-3205-31,OMEGA-3 FATTY ACID 10% - (NEO-PEDS),5.56,2.78,1.39,3.67,16
NDC,06332-3221-10,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",16.74,8.37,0.05,54.4,28
NDC,06332-3229-21,"INJECTION, PROTAMINE SULFATE, PER 10 MG",8.29,4.15,2.49,11.28,28
NDC,06332-3260-37,"INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML",24.33,12.17,6.19,33.09,28
NDC,06332-3269-22,"INJECTION, PROPOFOL, 10 MG",2.76,1.38,0.15,3.75,28
NDC,06332-3278-10,"INJECTION, VINBLASTINE SULFATE, 1 MG",23.380000000000003,11.690000000000001,6.99,114.92,28
NDC,06332-3281-10,"INJECTION, FLUPHENAZINE HCL, 1.25 MG",20.05,10.03,6.02,27.27,28
NDC,06332-3306-02,"INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG",17.55,8.775,3.42,28.86,28
NDC,06332-3379-05,"INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAVENOUS INJECTION, 25 MCG",2.58,1.29,0.77,3.5,28
NDC,06332-3401-20,"INJECTION, AZTREONAM, 100 MG",13.8,6.9,3.68,18.77,28
NDC,06332-3402-20,"INJECTION, AZTREONAM, 100 MG",10.2,5.1,3.06,13.87,28
NDC,06332-3407-03,"INJECTION, CAFFEINE CITRATE, 5 MG",25.92,12.96,3.35,35.25,28
NDC,06332-3411-15,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",46.63,23.31,0.23,63.41,28
NDC,06332-3411-25,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",30.015,15.01,0.23,227.67,28
NDC,06332-3417-10,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,27.03,13.52,6.76,17.84,16
NDC,06332-3434-41,"INJECTION, ACETAMINOPHEN (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0131, 10 MG",24.87,12.435,0.1,65.27,56
NDC,06332-3450-50,"INJECTION, PEMETREXED, NOT OTHERWISE SPECIFIED, 10 MG",306.18,78.88,2.8,1677.59,31
NDC,06332-3452-00,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",68.595,34.3,5.24,292.95,28
NDC,06332-3466-31,"INJECTION, BUPIVICAINE, NOT OTHERWISE SPECIFIED, 0.5 MG",233.0,116.5,0.02,316.88,28
NDC,06332-3473-02,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,2.55,1.27,0.64,1.68,16
NDC,06332-3482-57,"INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG",217.0,108.5,0.07,295.12,28
NDC,06332-3485-57,UNCLASSIFIED DRUGS,233.0,116.5,69.9,316.88,26
NDC,06332-3506-01,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",6.26,3.13,0.18,8.52,28
NDC,06332-3507-21,"INJECTION, MEROPENEM, 100 MG",11.65,5.83,0.63,33.33,28
NDC,06332-3508-01,"INJECTION, MEROPENEM, 100 MG",7.960000000000001,3.9800000000000004,0.63,12.07,56
NDC,06332-3517-01,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.12,3.08,0.3,8.43,84
NDC,06332-3540-05,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",6.43,3.21,0.3,8.74,28
NDC,06332-3540-11,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.29,0.65,0.3,1.75,28
NDC,06332-3586-21,"INJECTION, ENOXAPARIN SODIUM, 10 MG",219.67,109.83,0.87,316.88,28
NDC,06332-3596-03,"INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG",325.0,162.5,69.9,874.99,31
NDC,06332-3599-30,"INJECTION, DEFEROXAMINE MESYLATE, 500 MG",44.855000000000004,22.425,13.98,63.19,28
NDC,06332-3614-00,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",63.27,31.64,7.24,404.26,28
NDC,06332-3614-21,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",63.89,31.94,7.24,86.89,28
NDC,06332-3651-02,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",30.0,15.0,0.87,40.8,28
NDC,06332-3655-21,"INJECTION, ENOXAPARIN SODIUM, 10 MG",220.96,110.48,0.87,295.12,28
NDC,06332-3659-03,INDOMETHACIN 1 MG INTRAVENOUS SOLUTION,174.45,87.22,43.61,115.14,16
NDC,06332-3664-01,"INJECTION, DIPHENHYDRAMINE HCL, UP TO 50 MG",57.84,28.92,1.17,316.88,56
NDC,06332-3673-89,"INJECTION, PALONOSETRON HCL, 25 MCG",115.62,57.81,0.58,157.24,28
NDC,06332-3711-00,"INJECTION, LEUCOVORIN CALCIUM, PER 50 MG",17.17,8.58,5.15,23.35,28
NDC,06332-3733-10,"INJECTION, MESNA, 200 MG",22.46,11.23,2.81,115.55,28
NDC,06332-3739-12,"INJECTION, FAMOTIDINE, 0.25 MG",2.02,1.04,0.02,2.85,28
NDC,06332-3781-21,UNCLASSIFIED DRUGS,23.4,11.7,7.02,31.82,26
NDC,06332-3806-50,"INJECTION, FENTANYL CITRATE, 0.1 MG",4.03,2.01,1.21,5.48,28
NDC,06332-3820-04,FAT EMULSION (SMOFLIPID) 20% IV BAG (NEO/PEDS),155.0,77.5,38.75,102.3,16
NDC,06332-3820-74,FAT EMULSION (SMOFLIPID) 20% INFUSION,154.87,77.43,38.72,102.21,16
NDC,06332-3820-74,FAT EMULSION (SMOFLIPID) 20% SYRINGE (NEO/PEDS),149.97,74.99,37.49,98.98,16
NDC,06332-3821-10,"INJECTION, BORTEZOMIB, 0.1 MG",334.27500000000003,167.13500000000002,2.19,962.55,32
NDC,06332-3852-03,"INJECTION, HYDROMORPHONE, 0.1 MG",66.0,33.0,0.09,89.76,28
NDC,06332-3885-10,"INJECTION, LEVOTHYROXINE SODIUM (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J0650, 10 MCG",26.83,13.41,8.05,36.48,27
NDC,06332-3943-10,"INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG",19.35,9.675,2.56,31.8,28
NDC,06332-3983-23,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",22.13,11.06,1.8,45.37,28
NDC,06345-9103-10,"INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG",328.295,164.15,49.75,2382.19,31
NDC,06380-7500-05,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",11.495000000000001,5.75,0.03,15.68,28
NDC,06380-7600-55,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.97,2.98,0.03,8.12,28
NDC,06382-4008-34,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",20.0,10.0,5.0,13.2,16
NDC,06406-7216-01,METHOXSALEN 20 MCG/ML INJECTION SOLUTION,329.70000000000005,164.85000000000002,56.7,285.52,16
NDC,06425-3333-35,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",5.05,2.53,0.03,6.87,28
NDC,06425-3900-30,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,76.17,38.09,19.04,50.27,16
NDC,06438-0152-01,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,35.6,17.8,8.9,23.5,16
NDC,06440-6008-01,"INJECTION, NATALIZUMAB, 1 MG",76.88,38.44,23.06,5897.78,31
NDC,06440-6058-01,"INJECTION, NUSINERSEN, 0.1 MG",1920.53,960.26,576.16,28568.47,31
NDC,06440-6109-01,"INJECTION, TOFERSEN, 1 MG",439.71,219.86,131.91,598.01,27
NDC,06476-4300-20,"INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG",61.765,30.88,18.47,5897.78,31
NDC,06495-0362-04,"COCAINE HYDROCHLORIDE NASAL SOLUTION (GOPRELTO), 1 MG",3.28,1.64,0.98,4.45,26
NDC,06498-0104-01,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,13.065000000000001,6.535,3.75,9.9,16
NDC,06504-4999-81,HISTAMINE DICHLORIDE 6 MG/ML TOPICAL SOLUTION,2541.0,1270.5,635.25,1677.06,16
NDC,06516-2062-05,SUCRALFATE 100 MG/ML ORAL SUSPENSION,70.0,35.0,17.5,46.2,16
NDC,06516-2062-05,SUCRALFATE 100MG/ML SUSPENSION (PEDS),30.73,15.36,7.68,20.28,16
NDC,06516-2415-03,"BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 6 MG, BUT LESS THAN OR EQUAL TO 10 MG BUPRENORPHINE",32.77,16.38,9.83,44.56,28
NDC,06516-2416-03,"BUPRENORPHINE/NALOXONE, ORAL, LESS THAN OR EQUAL TO 3 MG BUPRENORPHINE",23.55,11.77,7.06,32.03,28
NDC,06516-2826-34,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,24.27,12.13,6.07,16.02,16
NDC,06516-2914-46,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",33.12,16.56,9.94,45.05,28
NDC,06521-9006-00,"INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ",15.22,7.61,0.2,741.2,28
NDC,06521-9014-01,AMPICILLIN 250 MG SOLUTION FOR INJECTION,56.0,28.0,14.0,36.96,16
NDC,06521-9014-01,"INJECTION, AMPICILLIN SODIUM, 500 MG",57.86,28.93,0.97,78.69,28
NDC,06521-9190-30,"INJECTION, VORICONAZOLE, 10 MG",3.65,1.83,1.1,4.97,28
NDC,06521-9429-50,"INJECTION, ARGATROBAN, 1 MG (FOR NON-ESRD USE)",6.31,3.16,1.01,128.98,31
NDC,06559-7406-01,"INJECTION, FAM-TRASTUZUMAB DERUXTECAN-NXKI, 1 MG",85.18,42.59,25.56,2382.19,31
NDC,06564-9201-75,PEG3350 100 GRAM-SOD SULF 7.5 GRAM-NACL-KCL-ASCORBATE-C ORAL PWDR PACK,238.79,119.4,59.7,157.6,16
NDC,06564-9551-02,"INJECTION, METHYLNALTREXONE, 0.1 MG",114.275,57.14,1.14,234.0,28
NDC,06575-7300-01,"INJECTION, NALTREXONE, DEPOT FORM, 1 MG",118.025,59.01,3.54,1286.64,31
NDC,06575-7401-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",7.34,3.67,2.2,1677.59,31
NDC,06575-7402-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",14.76,7.38,4.43,1677.59,31
NDC,06575-7403-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA), 1 MG",16.01,8.01,4.8,1677.59,31
NDC,06575-7500-03,"INJECTION, ARIPIPRAZOLE LAUROXIL, (ARISTADA INITIO), 1 MG",14.77,7.39,4.43,1286.64,31
NDC,06586-2018-01,CEPHALEXIN 250 MG CAPSULE,20.0,10.0,5.0,13.2,16
NDC,06586-2391-10,"ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE ",1.5899999999999999,0.79,0.02,2.21,28
NDC,06586-2528-90,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",48.0,24.0,12.0,31.68,16
NDC,06586-2677-01,ALPRAZOLAM 0.5 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,06630-2102-01,"INJECTION, TREPROSTINIL, 1 MG",62.79,31.4,18.84,604.48,31
NDC,06630-2105-01,"INJECTION, TREPROSTINIL, 1 MG",54.59,27.3,16.38,604.48,31
NDC,06630-2110-01,"INJECTION, TREPROSTINIL, 1 MG",49.56,24.78,14.87,604.48,31
NDC,06655-3001-01,ASPIRIN 325 MG TABLET,10.99,5.49,2.75,7.25,16
NDC,06655-3004-01,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,12.36,6.18,3.09,8.16,16
NDC,06665-8234-01,UNCLASSIFIED BIOLOGICS,51.2,25.6,15.36,69.63,26
NDC,06673-3948-23,"INJECTION, CETUXIMAB, 10 MG",374.09000000000003,187.04500000000002,66.58,2382.19,31
NDC,06673-3958-23,"INJECTION, CETUXIMAB, 10 MG",208.06,104.03,62.42,2382.19,31
NDC,06679-4015-25,SEVOFLURANE 99.97 % INHALATION LIQUID,220.77,110.38,55.19,145.7,16
NDC,06679-4151-01,"INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL",180.75,90.38,54.23,245.82,28
NDC,06679-4155-01,"INJECTION, BACLOFEN, 10 MG",574.64,287.32,172.39,781.51,31
NDC,06706-6005-01,"INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MICROGRAM",163.085,81.53999999999999,38.93,604.48,31
NDC,06738-6130-51,"INJECTION, EPTINEZUMAB-JJMR, 1 MG",58.73,29.37,17.62,1286.64,31
NDC,06745-7163-02,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,261.63,130.82,65.41,172.68,16
NDC,06745-7196-00,"INJECTION, THIAMINE HCL, 100 MG",85.45,42.72,2.99,242.32,28
NDC,06745-7210-05,"INJECTION, CIDOFOVIR, 375 MG",2832.4,1416.2,400.01,3852.06,31
NDC,06745-7217-20,"INJECTION, METHADONE HCL, UP TO 10 MG",86.23,43.115,24.38,124.0,56
NDC,06745-7218-10,"INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG",108.08,54.04,28.43,146.99,28
NDC,06745-7220-00,"INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG",48.99,24.49,14.7,66.62,27
NDC,06745-7340-00,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",11.3,5.65,0.05,15.37,28
NDC,06745-7385-10,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",1.47,0.74,0.3,2.0,28
NDC,06745-7409-00,"INJECTION, HALOPERIDOL DECANOATE, PER 50 MG",125.945,62.975,6.5,295.12,28
NDC,06745-7426-00,"INJECTION, HALOPERIDOL, UP TO 5 MG",224.02,112.01,1.2,312.53,28
NDC,06745-7436-50,"INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG",202.0,101.0,4.59,274.72,28
NDC,06745-7437-00,"INJECTION, DOXYCYCLINE HYCLATE, 1 MG",33.915,16.96,0.17,90.11,28
NDC,06745-7833-06,"INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG",377.88,188.94,67.6,1677.59,31
NDC,06745-7855-02,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",7.82,3.91,0.87,10.64,28
NDC,06745-7856-20,"INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)",1.76,0.88,0.53,2.39,28
NDC,06787-7538-07,"TEMOZOLOMIDE, ORAL, 5 MG",21.73,10.87,0.89,29.56,28
NDC,06787-7539-07,"TEMOZOLOMIDE, ORAL, 5 MG",6.82,3.41,0.89,9.27,28
NDC,06797-9002-01,"HISTRELIN IMPLANT (SUPPRELIN LA), 50 MG",51866.0,25933.0,88.32,140780.4,31
NDC,06808-4097-11,ATORVASTATIN 10 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06808-4098-11,ATORVASTATIN 20 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06808-4099-11,ATORVASTATIN 40 MG TABLET,11.58,5.79,2.89,7.64,16
NDC,06808-4157-11,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",30.0,15.0,7.5,19.8,16
NDC,06808-4269-11,HYDROXYCHLOROQUINE 200 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06808-4280-01,ETHAMBUTOL 400 MG TABLET,8.63,4.31,2.16,5.69,16
NDC,06808-4299-11,TAMSULOSIN 0.4 MG CAPSULE,20.0,10.0,5.0,13.2,16
NDC,06808-4354-01,OXYCODONE 5 MG TABLET,10.07,5.03,2.52,6.65,16
NDC,06808-4450-11,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",9.21,4.61,0.33,12.53,28
NDC,06808-4536-11,CLOPIDOGREL 75 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06808-4907-11,"MYCOPHENOLIC ACID, ORAL, 180 MG",20.64,10.32,0.53,28.08,28
NDC,06808-4915-95,"SIROLIMUS, ORAL, 1 MG",31.38,15.69,1.6,42.68,28
NDC,06808-4918-95,"MYCOPHENOLIC ACID, ORAL, 180 MG",13.58,6.79,0.53,18.47,28
NDC,06808-4956-95,"SIROLIMUS, ORAL, 1 MG",25.65,12.83,1.6,34.89,28
NDC,06813-5811-02,"INJECTION, CERLIPONASE ALFA, 1 MG",199.13,99.57,59.74,20978.86,31
NDC,06818-0352-09,SERTRALINE 50 MG TABLET,12.31,6.15,3.08,8.12,16
NDC,06818-0981-01,LISINOPRIL 20 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,06838-2918-18,"METHYLPREDNISOLONE ORAL, PER 4 MG",3.35,1.67,0.23,4.55,28
NDC,06851-6521-42,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",262.34,131.17,57.87,467.62,31
NDC,06851-6521-63,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",360.65,180.33,87.58,490.49,31
NDC,06872-7712-01,"INJECTION, LURBINECTEDIN, 0.1 MG",614.565,307.28,184.49,4737.06,31
NDC,06872-7900-01,"INJECTION, ASPARAGINASE, RECOMBINANT, (RYLAZE), 0.1 MG",200.82999999999998,100.41499999999999,65.1,20978.86,31
NDC,06880-3612-10,TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,248.63,124.32,62.16,164.1,16
NDC,06881-7134-50,"INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG",65.845,32.92,13.5,1677.59,31
NDC,06898-2850-03,"INJECTION, IMMUNE GLOBULIN, (OCTAGAM), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG",358.495,179.245,78.19,1677.59,31
NDC,06899-2301-03,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",1.9,0.95,0.57,3.09,28
NDC,06899-2304-03,"TACROLIMUS, EXTENDED RELEASE, (ENVARSUS XR), ORAL, 0.25 MG",1.03,0.51,0.31,3.09,28
NDC,06909-7223-16,ALENDRONATE 35 MG TABLET,75.0,37.5,18.75,49.5,16
NDC,06909-7870-67,"INJECTION, LANREOTIDE, (CIPLA), 1 MG",267.82,133.91,63.06,5897.78,31
NDC,06923-8110-02,DOXYCYCLINE HYCLATE 100 MG CAPSULE,20.0,10.0,5.0,13.2,16
NDC,06923-8120-42,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,249.95,124.97,62.49,164.97,16
NDC,06923-8207-71,PROPRANOLOL 10 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,06931-5904-01,LORAZEPAM 0.5 MG TABLET,18.564999999999998,9.285,4.8,14.61,16
NDC,06931-5905-01,LORAZEPAM 1 MG TABLET,18.634999999999998,9.32,3.75,14.7,16
NDC,06937-4919-10,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",97.78,48.89,29.33,132.98,26
NDC,06937-4953-50,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE (GLUCOSTABILIZER),101.05,50.53,25.26,66.69,16
NDC,06937-4953-50,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE (PEDS),101.0,50.5,25.25,66.66,16
NDC,06948-8003-01,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",712.5,356.25,213.75,47865.64,31
NDC,06991-8899-01,"INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG",37.06,18.53,4.05,154.11,32
NDC,07000-4430-09,KETAMINE 50 MG/5 ML (10 MG/ML) IN NS IV SYRINGE,101.58,50.79,24.0,76.97,16
NDC,07006-9005-01,"INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG",65.57,32.79,1.06,308.18,28
NDC,07006-9261-01,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,91.16,45.58,22.79,60.17,16
NDC,07010-0424-01,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,1289.315,644.66,84.4,1479.07,16
NDC,07011-4101-01,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",230.71,115.36,73.1,2382.19,31
NDC,07011-4130-01,"INJECTION, PEGFILGRASTIM-CBQV (UDENYCA), BIOSIMILAR, 0.5 MG",767.3399999999999,383.66999999999996,114.96,2382.19,31
NDC,07012-1156-81,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",109.66,54.83,0.55,303.11,93
NDC,07012-1157-01,"INJECTION, FILGRASTIM-AYOW, BIOSIMILAR, (RELEUKO), 1 MICROGRAM",217.0,108.5,0.39,233.0,31
NDC,07012-1157-31,"INJECTION, METHYLPREDNISOLONE ACETATE, 1 MG",1.96,0.98,0.12,227.85,28
NDC,07012-1163-01,"INJECTION, THIOTEPA, NOT OTHERWISE SPECIFIED, 1 MG",1421.2,710.6,14.62,1932.83,27
NDC,07012-1163-11,"INJECTION, THIOTEPA, NOT OTHERWISE SPECIFIED, 1 MG",311.35,155.68,14.62,423.44,27
NDC,07025-7563-01,"INJECTION, BACLOFEN, 10 MG",481.63,240.81,144.49,655.01,31
NDC,07046-1025-04,"Influenza vaccine, inactivated",134.5,67.25,26.68,215.02,32
NDC,07067-7101-51,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",10.41,5.125,2.03,12.85,26
NDC,07070-0290-22,"INJECTION, TESTOSTERONE CYPIONATE, 1 MG",217.0,108.5,0.05,316.88,28
NDC,07071-0121-05,ALLOPURINOL 300 MG TABLET,20.0,10.0,5.0,13.2,16
NDC,07072-0720-10,"INJECTION, ZICONOTIDE, 1 MICROGRAM",90.4,45.2,17.44,1677.59,31
NDC,07072-0950-36,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",577.495,288.745,174.0,4072.06,32
NDC,07072-0951-30,"GOSERELIN ACETATE IMPLANT, PER 3.6 MG",575.33,287.67,172.17,2572.76,32
NDC,07075-2138-12,"PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEE",16.52,8.26,0.48,22.47,28
NDC,07075-6604-44,"TOBRAMYCIN, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, UNIT DOSE FORM, ADMINISTERED THROUGH DME, PER 300 MILLIGRAMS",32.04,16.02,9.61,43.57,28
NDC,07075-6629-25,PHENYLEPHRINE 2.5 % EYE DROPS,221.535,110.77,23.86,229.44,16
NDC,07075-6651-25,ATROPINE 1 % EYE DROPS,125.28,62.64,31.32,82.69,16
NDC,07084-2120-01,"INJECTION, MEROPENEM AND VABORBACTAM, 10MG/10MG (20MG)",5.06,2.53,1.52,154.11,31
NDC,07084-2160-01,"INJECTION, MINOCYCLINE HYDROCHLORIDE, 1 MG",5.59,2.8,1.68,7.6,27
NDC,07086-0751-41,"INJECTION, FAMOTIDINE, 0.25 MG",1.66,0.83,0.02,2.26,28
NDC,07126-6200-12,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",69.24,34.62,15.6,136.22,26
NDC,07126-6200-21,ROCURONIUM 50 MG/5 ML (10 MG/ML) (RSI KIT),88.84,44.42,22.21,58.64,16
NDC,07126-6200-21,ROCURONIUM 50 MG/5 ML (10 MG/ML) INTRAVENOUS SYRINGE,64.53,32.27,16.13,42.59,16
NDC,07126-6525-01,"COMPOUNDED DRUG, NOT OTHERWISE CLASSIFIED",154.99,77.5,46.5,210.79,26
NDC,07126-6802-01,ARGININE 25 MG-LYSINE 25MG/ML IN STERILE WATER INTRAVENOUS SOLUTION,957.9,478.95,239.48,632.21,16
NDC,07126-6901-11,"INJECTION, PHENYLEPHRINE HYDROCHLORIDE, 20 MICROGRAMS",1.84,0.92,0.02,2.51,28
NDC,07126-6901-11,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE (RSI KIT),71.66,35.83,17.92,47.3,16
NDC,07128-6207-11,"INJECTION, FENTANYL CITRATE, 0.1 MG",80.84,40.42,1.96,109.94,28
NDC,07128-7119-01,"AXICABTAGENE CILOLEUCEL, UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS, INCLUDING LEUKAPHERESIS AND DOSE PREPARATION PROCEDURES, PER THERAPEUTIC DOSE",2961420.0,1480710.0,56281.85,4027531.2,29
NDC,07128-8103-20,"INJECTION, BENDAMUSTINE HYDROCHLORIDE, 1 MG",48.915,24.46,3.38,2382.19,31
NDC,07128-8803-20,"INJECTION, MYCOPHENOLATE MOFETIL, 10 MG",1.69,0.85,0.51,604.48,32
NDC,07133-6100-11,"INJECTION, GIVOSIRAN, 0.5 MG",289.265,144.63,67.16,28568.47,31
NDC,07138-4511-08,MOXIFLOXACIN (PF) 5 MG/ML OPHTHALMIC INJECTION,142.96,71.48,35.74,94.35,16
NDC,07139-9102-81,"ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED",10.0,5.0,0.83,11.73,26
NDC,07144-9079-51,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.36,0.68,0.08,1.84,28
NDC,07144-9079-57,"INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG",1.21,0.6,0.08,1.64,28
NDC,07169-9201-28,CENOBAMATE 12.5/25 MG DOSE PACK,10.25,5.12,2.56,6.76,16
NDC,07214-0452-31,WHITE PETROLATUM 41 % TOPICAL OINTMENT,37.65,18.83,9.41,24.85,16
NDC,07226-6127-01,"INJECTION, DICYCLOMINE HCL, UP TO 20 MG",220.25,110.125,18.69,316.88,28
NDC,07226-6251-01,"INJECTION, CALCITRIOL, 0.1 MCG",11.33,5.67,1.96,15.41,28
NDC,07249-3101-40,"MITOMYCIN PYELOCALYCEAL INSTILLATION, 1 MG",1219.01,609.5,365.7,20978.86,31
NDC,07269-4515-01,"INJECTION, CALASPARGASE PEGOL-MKNL, 10 UNITS",265.745,132.875,66.01,9401.8,31
NDC,07269-4954-01,"INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL",99065.685,49532.845,19791.36,134728.9,31
NDC,07290-3853-01,"INJECTION, MIRVETUXIMAB SORAVTANSINE-GYNX, 1 MG",230.595,115.3,62.28,20978.86,31
NDC,07315-0150-06,"INJECTION, UBLITUXIMAB-XIIY, 1MG",238.33,119.17,71.5,20978.86,31
NDC,07353-5208-01,"INJECTION, TAFASITAMAB-CXIX, 2 MG",50.305,25.15,15.07,4737.06,31
NDC,07370-2140-71,INDOMETHACIN 100 MG RECTAL SUPPOSITORY,775.0,387.5,193.75,511.5,16
NDC,07431-2028-32,MELATONIN 1 MG TABLET,10.0,5.0,2.5,6.6,16
NDC,07452-7022-01,"INJECTION, MARGETUXIMAB-CMKB, 5 MG",128.36,64.18,38.51,4737.06,31
NDC,07598-7150-01,"INJECTION, INEBILIZUMAB-CDON, 1 MG",1619.16,809.58,485.75,20978.86,31
NDC,07604-5009-96,"INJECTION, HYDROMORPHONE, 0.1 MG",8.435,4.220000000000001,0.09,306.0,28
NDC,07604-5216-00,"INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG",3.09,1.55,0.15,4.2,28
NDC,07607-5101-01,"INJECTION, CARFILZOMIB, 1 MG",134.555,67.275,30.75,1677.59,31
NDC,07607-5102-01,"INJECTION, CARFILZOMIB, 1 MG",118.45,59.23,35.54,1677.59,31
NDC,07607-5103-01,"INJECTION, CARFILZOMIB, 1 MG",139.3,69.65,41.79,1677.59,31
NDC,07612-5150-11,Rabies immune globulin for injection beneath the skin and/or into muscle,149.0,74.5,39.24,1677.59,31
NDC,07620-4100-25,"IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM",11.13,5.57,0.66,15.14,28
NDC,07631-0001-25,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",290.01,145.0,11.07,394.41,32
NDC,07632-9301-25,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,24.535,12.27,6.38,17.39,16
NDC,07632-9330-41,CALCIUM CHLORIDE 10 % INJECTION (PEDS),82.33,41.17,20.58,54.34,16
NDC,07632-9331-81,"INJECTION, EPINEPHRINE (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG",6.13,3.06,0.91,9.01,28
NDC,07632-9331-81,"INJECTION, EPINEPHRINE, NOT OTHERWISE SPECIFIED, 0.1 MG",86.0,43.0,0.71,116.96,28
NDC,07632-9335-21,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,98.94999999999999,49.474999999999994,23.76,64.61,16
NDC,07632-9336-91,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",3.07,1.54,0.12,306.0,84
NDC,07811-2011-04,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,29.9,14.95,7.48,19.74,16
NDC,07820-6114-03,MOMETASONE 220 MCG BREATH ACTIVATED POWDER AEROSOL (BUNDLED),125.66,62.83,31.41,82.93,16
NDC,07820-6145-01,"ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES",3036.78,1518.39,570.27,4130.03,32
NDC,07985-4400-50,MULTIVITAMINS WITH MINERALS TAB (BUNDLED),8.0,4.0,2.0,5.28,16
NDC,07995-2110-01,"INJECTION, LONCASTUXIMAB TESIRINE-LPYL, 0.075 MG",654.86,327.43,196.46,20978.86,31
NDC,08065-1830-85,PROVISC 10 MG/ML DISP SYRNG,918.68,459.34,229.67,606.33,16
NDC,08065-1831-50,DUOVISC VISCOELASTIC SYSTEM,501.72,250.86,125.43,331.14,16
NDC,08065-1839-05,VISCOAT SYRINGE,160.27,80.13,40.07,105.78,16
NDC,08080-3153-50,"INJECTION, SIROLIMUS PROTEIN-BOUND PARTICLES, 1 MG",274.86,137.43,82.46,9401.8,31
NDC,08129-8811-01,"INJECTION, CYCLOPHOSPHAMIDE, NOT OTHERWISE SPECIFIED, 5 MG",6.115,3.06,0.97,9.26,27
NDC,08215-4044-91,PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLUTION,224.11,112.06,56.03,2187.29,16
NDC,08215-4045-14,"INJECTION, PEGYLATED INTERFERON ALFA-2A, 180 MCG PER ML",2095.565,1047.7849999999999,69.9,5383.06,30
NDC,08270-5002-01,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",190.86,95.43,42.72,431.23,27
NDC,08270-5010-01,"INJECTION, EPCORITAMAB-BYSP, 0.16 MG",375.73,187.86,61.12,755.78,27
NDC,08290-3064-14,HEPARIN 50 UNITS/5 ML (10/ML),19.375,9.690000000000001,4.6,13.42,32
NDC,08290-3064-14,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",15.27,7.64,0.03,22.03,84
NDC,08290-3064-24,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",1.05,0.55,0.03,1.85,56
NDC,08295-9111-01,"INJECTION, IMETELSTAT, 1 MG",198.195,99.095,47.67,387.83,27
NDC,08295-9112-01,"INJECTION, IMETELSTAT, 1 MG",212.20999999999998,106.10499999999999,73.45,11256.4,27
NDC,08325-7014-11,"INJECTION, INSULIN, PER 5 UNITS",9.34,4.665,0.87,13.34,28
NDC,08541-2034-62,VIAFLEX EMPTY STERILE BAG 150 ML,42.0,21.0,10.5,27.72,16
NDC,08544-6369-91,SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRINGE,337.0,168.5,84.25,222.42,16
NDC,08913-0202-01,"HYALURONAN OR DERIVATIVE, DUROLANE, FOR INTRA-ARTICULAR INJECTION, 1 MG",64.89,32.45,10.76,604.48,31
NDC,08913-0444-41,"HYALURONAN OR DERIVATIVE, HYALGAN, SUPARTZ OR VISCO-3, FOR INTRA-ARTICULAR INJECTION, PER DOSE",763.0,381.5,120.4,1037.68,32
NDC,09999-9000-45,"INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG",71.0,35.5,21.3,96.56,28
NDC,09999-9000-56,"INJECTION, ACYCLOVIR, 5 MG",4.24,2.115,0.2,8.22,56
NDC,09999-9000-58,"INJECTION, CEFAZOLIN SODIUM, 500 MG",139.9,69.945,1.37,195.74,56
NDC,09999-9000-59,"INJECTION, CEFEPIME HYDROCHLORIDE, 500 MG",35.54,17.77,1.44,48.33,28
NDC,09999-9000-61,"INJECTION, CEFTAZIDIME, PER 500 MG",35.489999999999995,17.744999999999997,2.43,49.11,56
NDC,09999-9000-76,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",66.8,33.4,3.58,90.85,28
NDC,09999-9000-79,"INJECTION, HYDRALAZINE HCL, UP TO 20 MG",67.33,33.67,7.24,91.57,28
NDC,09999-9000-80,"INJECTION, LEVETIRACETAM, 10 MG",5.04,2.52,0.07,6.85,28
NDC,09999-9000-84,"INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, 5 MG",36.46,18.23,0.27,62.56,56
NDC,09999-9000-89,PANTOPRAZOLE 0.4 MG/ML INJECTION DILUTION (PEDS),3.06,1.53,0.77,2.02,16
NDC,09999-9000-94,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",18.5,9.25,0.05,25.16,28
NDC,09999-9000-94,VANCOMYCIN 5 MG/ML LOCK SOLUTION,33.0,16.5,8.25,21.78,16
NDC,09999-9001-05,FAMOTIDINE 2 MG/ML INJECTION DILUTION (PEDS),13.64,6.82,3.41,9.0,16
NDC,09999-9001-06,"INJECTION, CALCIUM GLUCONATE, NOT OTHERWISE SPECIFIED, 10 MG",1.45,0.73,0.05,1.98,28
NDC,09999-9001-31,"HEPARIN 10,000 UNITS/500 ML PHOTOPHERESIS SOLUTION BAG",20.6,10.3,5.15,13.6,16
NDC,09999-9001-50,"INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG",66.0,33.0,0.23,89.76,28
NDC,09999-9001-51,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",67.5,33.75,5.02,91.8,28
NDC,09999-9001-52,"INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM/0.125 GRAMS (1.125 GRAMS)",46.56,23.28,1.8,63.32,28
NDC,09999-9001-63,"INJECTION, SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG",57.43,28.715,3.65,122.13,28
NDC,09999-9001-65,INDOMETHACIN 0.1 MG/ML INJECTION DILUTION (NEO),129.0,64.5,32.25,85.14,16
NDC,09999-9001-75,VALPROATE SODIUM 20 MG/ML INJECTION (NEO-PEDS),6.45,3.23,1.61,4.26,16
NDC,09999-9001-83,SODIUM PHOSPHATE 0.116 MMOL/ML PERIPHERAL IV (NEO-PEDS),2.84,1.42,0.71,1.88,16
NDC,09999-9001-85,POTASSIUM PHOSPHATE 0.065  MMOL/ML PERIPHERAL IV (NEO-PEDS),2.38,1.19,0.6,1.57,16
NDC,09999-9001-89,DEXTROSE 30 % IN WATER (D30W) INTRAVENOUS SOLUTION,103.0,51.5,25.75,67.98,16
NDC,09999-9001-94,"INJECTION, COSYNTROPIN, 0.25 MG",70.0,35.0,21.0,95.2,28
NDC,09999-9002-04,LABETALOL 2.5 MG/ML NACL 0.9% INJECTION DILUTION (NEO),39.25,19.63,9.81,25.91,16
NDC,70092-1005-38,"INJECTION, AMIODARONE HYDROCHLORIDE, 30 MG",3.36,1.68,0.68,4.57,28
NDC,70092-1119-44,KETAMINE 50 MG/5 ML-0.9% NACL,94.46000000000001,47.230000000000004,19.67,72.75,32
NDC,70092-1269-37,FENTANYL 2 MCG-BUP 0.0625%-NS,154.99,77.5,38.75,102.3,16
NDC,70092-1290-49,"INJECTION, HYDROMORPHONE, 0.1 MG",3.75,1.87,0.09,5.09,28
NDC,70092-1310-46,METHOHEXITAL 100 MG/10ML-WATER,149.82,74.91,37.46,98.88,16
NDC,70092-1433-50,R.E.C.K.(ROPIV-EPI-CLON-KETOR),191.43,95.72,47.86,126.35,16
NDC,70092-1494-49,"INJECTION, FENTANYL CITRATE, 0.1 MG",7.68,3.84,1.96,11.04,84
NDC,70092-1617-46,EPINEPHRINE 100 MCG/10 ML-D5W,75.59,37.79,18.9,49.89,16
NDC,99999-2004-88,LEVOTHYROXINE 50 MCG (DYE-FREE),11.0,5.5,2.75,7.26,16
NDC,99999-3000-22,"INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG",535.83,267.92,78.03,2382.19,31
NDC,99999-3000-25,"INFUSION, ALBUMIN (HUMAN), 5%, 250 ML",361.0,180.5,87.58,490.96,31
NDC,99999-3000-31,"INFUSION, ALBUMIN (HUMAN), 25%, 50 ML",361.0,180.5,87.58,490.96,31
NDC,99999-3000-55,VANCOMYCIN (PF)INTRAVENTRICULAR SYRINGE,39.5,19.75,9.88,26.07,16
NDC,99999-3000-64,"INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG",56.33,28.17,3.58,76.61,28
NDC,99999-3000-79,DEXTROSE 12.5% WATER IV SOLN (PEDS-NEO),103.0,51.5,25.75,67.98,16
NDC,99999-3000-80,DEXTROSE 15% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
NDC,99999-3000-84,DEXTROSE 25% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
NDC,99999-3000-88,DEXTROSE 7.5% WATER IV INFUSION (NEO-PEDS),103.0,51.5,25.75,67.98,16
NDC,99999-3001-35,LIPIODOL ULTRA-FLUIDE 48% INJECTION,3569.35,1784.67,892.34,2355.77,16
NDC,99999-3001-74,"INJECTION, PROPRANOLOL HCL, UP TO 1 MG",82.0,41.0,18.13,111.52,28
NDC,99999-3001-94,HTK PERFUSION SOLUTION,1386.07,693.03,346.52,914.81,16
NDC,99999-3002-11,"INJECTION, FENTANYL CITRATE, 0.1 MG",99.0,49.5,1.96,134.64,28
NDC,99999-3002-18,AMPHOTERICIN B 50 MCG/ML INTRA-OPHTHALMIC SOLUTION,99.0,49.5,24.75,65.34,16
NDC,99999-3002-32,"INJECTION, NICARDIPINE, 0.1 MG",1.28,0.64,0.12,1.75,28
NDC,99999-3002-77,ROCURONIUM IN NS 2 MG/ML INJECTION DILUTION (NEO),69.0,34.5,17.25,45.54,16
NDC,99999-3003-11,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",5.16,2.58,0.3,7.02,28
NDC,99999-3003-40,"INJECTION, VORICONAZOLE, 10 MG",237.0,118.5,1.24,322.32,28
NDC,99999-3003-49,"INJECTION, VON WILLEBRAND FACTOR COMPLEX (HUMATE-P), PER IU VWF:RCO",3.87,1.93,1.16,4737.06,31
NDC,99999-3003-51,"INJECTION, FACTOR IX (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER IU, NOT OTHERWISE SPECIFIED",3.64,1.82,1.09,5897.78,31
NDC,99999-3003-56,"TACROLIMUS, PARENTERAL, 5 MG",488.0,244.0,145.38,663.68,31
NDC,99999-3003-60,"LIDOCAINE 1%, BUFFERED",216.6,108.3,16.5,142.96,16
NDC,99999-3003-73,"INJECTION, FOSCARNET SODIUM, PER 1000 MG",127.0,63.5,11.07,172.72,32
NDC,99999-3003-78,"PROTHROMBIN COMPLEX CONCENTRATE (HUMAN), KCENTRA, PER I.U. OF FACTOR IX ACTIVITY",6.385,3.19,1.85,2382.19,93
NDC,99999-3003-90,"INJECTION, ENOXAPARIN SODIUM, 10 MG",71.0,35.5,0.87,96.56,28
NDC,99999-3003-91,"ANTITHROMBIN III (HUMAN), PER I.U.",10.59,5.3,3.18,5897.78,31
NDC,99999-3004-02,"INJECTION, INSULIN, PER 5 UNITS",11.34,5.67,0.87,15.43,28
NDC,99999-3004-02,UNCLASSIFIED BIOLOGICS,6.08,3.04,1.82,8.27,26
NDC,99999-3004-05,"INJECTION, INSULIN, PER 5 UNITS",12.68,6.34,0.87,17.25,28
NDC,99999-3004-27,CEFTAZIDIME 2 MG/0.1 ML INTRAVITREAL SOLUTION,148.0,74.0,37.0,97.68,16
NDC,99999-3004-29,VANCOMYCIN 1 MG/0.1 ML INTRAVITREAL INJECTION,127.5,63.75,31.88,84.15,16
NDC,99999-3004-38,"INJECTION, ANTIHEMOPHILIC FACTOR VIII/VON WILLEBRAND FACTOR COMPLEX (HUMAN), PER FACTOR VIII I.U.",3.26,1.63,0.98,4737.06,31
NDC,99999-3004-40,NOREPINEPHRINE BITARTRATE 16 MG/250 ML (64 MCG/ML) IV (FOR ADS),178.33,89.17,44.58,117.7,16
NDC,99999-3004-54,"INJECTION, INSULIN, PER 5 UNITS",7.75,3.875,0.87,10.54,140
NDC,99999-3004-64,NITROGLYCERIN 400 MCG/10 ML IV SYRINGE (OR PACK),163.8,81.9,40.95,108.11,16
NDC,99999-3004-67,"INJECTION, INSULIN, PER 5 UNITS",65.45,32.73,0.87,89.01,28
NDC,99999-3004-75,"INJECTION, OXYTOCIN, UP TO 10 UNITS",41.59,20.79,4.44,64.18,84
NDC,99999-3004-85,AZITHROMYCIN 500 MG IV PIGGYBACK (FOR ADS),155.0,77.5,38.75,102.3,16
NDC,99999-3005-00,EPOPROSTENOL 30 MCG/ML INHALATION SOLUTION,265.0,132.5,66.25,174.9,16
NDC,99999-3005-26,"INJECTION, MORPHINE SULFATE (FRESENIUS KABI), NOT THERAPEUTICALLY EQUIVALENT TO J2270, UP TO 10 MG",47.14,23.57,11.17,157.12,28
NDC,99999-3005-48,"INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U.",3.15,1.57,0.94,2382.19,31
NDC,99999-3005-51,"INJECTION, HEPARIN SODIUM, PER 1000 UNITS",38.99,19.5,0.3,53.03,28
NDC,99999-3005-81,"INJECTION, MAGNESIUM SULFATE, PER 500 MG",4.09,2.05,0.68,5.57,28
NDC,99999-3005-83,PHENYLEPHRINE 100 MCG/1 ML SYRINGE,29.8,14.9,7.45,19.67,16
NDC,99999-3005-93,"INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10 UNITS",1.19,0.59,0.03,1.62,28
NDC,99999-3005-95,"INJECTION, MORPHINE SULFATE, UP TO 10 MG",33.28,16.645,5.02,46.09,56
NDC,99999-3006-00,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",153.865,76.935,0.76,307.16,28
NDC,99999-3006-01,"INJECTION, CEFTRIAXONE SODIUM, PER 250 MG",217.0,108.5,0.76,314.55,28
NDC,99999-3006-03,FENTANYL 2 MCG/ML-BUPIVACAINE 0.0625% INTRATHECAL INFUSION (L+D),155.0,77.5,38.75,102.3,16
NDC,99999-3006-03,FENTANYL-BUPIVACAINE IN NS (PF) 2 MCG/ML-0.0625 % INFUSION (PIEB),155.0,77.5,38.75,102.3,16
NDC,99999-3006-08,"INJECTION, NALOXONE HYDROCHLORIDE, NOT OTHERWISE SPECIFIED, 0.01 MG",85.0,42.5,0.12,115.6,28
NDC,99999-3006-26,"INJECTION, FENTANYL CITRATE, 0.1 MG",99.0,49.5,1.96,134.64,28
NDC,99999-3006-73,TPN - NEONATAL STARTER INFUSION,327.0,163.5,81.75,215.82,16
NDC,99999-3006-77,"SODIUM BICARBONATE 150 MEQ/1,000 ML IN DEXTROSE 5 % INTRAVENOUS",5.15,2.58,1.29,3.4,16
NDC,99999-3006-89,"INJECTION, ALTEPLASE RECOMBINANT, 1 MG",493.19,246.6,121.68,670.74,31
NDC,99999-3006-99,AMIODARONE 900 MG/500 ML (1.8 MG/ML) IN NACL 0.9% IV BAG,79.0,39.5,19.75,52.14,16
NDC,99999-3007-03,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",77.5,38.75,0.05,105.4,28
NDC,99999-4000-52,OPIUM DEODORIZED TINCTURE 0.6 ML SYRINGE,73.0,36.5,18.25,48.18,16
NDC,99999-4000-67,LABETALOL 40 MG/ML ORAL COMPOUND SUSPENSION (PEDS),9.0,4.5,2.25,5.94,16
NDC,99999-4000-70,STOMATITIS COCKTAIL (PEDS),58.0,29.0,14.5,38.28,16
NDC,99999-4000-91,"TEMOZOLOMIDE, ORAL, 5 MG",43.46,21.73,0.89,59.11,28
NDC,99999-4001-66,GLUCOSE TOLERANCE TEST 0.33 G/ML ORAL SOLUTION (PEDS),12.36,6.18,3.09,8.16,16
NDC,99999-4001-66,GLUCOSE TOLERANCE TEST SOLUTION 100 G/296 ML,28.0,14.0,7.0,18.48,16
NDC,99999-4001-86,"INJECTION, DEXAMETHASONE SODIUM PHOSPHATE, 1 MG",2.42,1.21,0.18,3.29,28
NDC,99999-4002-43,"TACROLIMUS, IMMEDIATE RELEASE, ORAL, 1 MG",17.85,8.92,0.33,24.27,28
NDC,99999-5000-01,"INJECTION, BEVACIZUMAB, 10 MG",237.0,118.5,71.1,2382.19,31
NDC,99999-5000-02,AMIKACIN 400 MCG/0.1 ML INTRAVITREAL SOLUTION,75.0,37.5,18.75,49.5,16
NDC,99999-5000-26,"INJECTION, VORICONAZOLE, 10 MG",3.9,1.95,1.17,5.3,28
NDC,99999-5000-99,HDM DEXTROSE 5% IN WATER (D5W) IV FLUSH SYRINGE 20 ML RPKG,56.65,28.325,2.58,67.98,16
NDC,99999-7000-88,ARREST CART,798.8,399.4,199.7,527.21,16
NDC,99999-7001-67,"INJECTION, VANCOMYCIN HYDROCHLORIDE, 10 MG",23.88,11.94,0.05,84.0,17
NDC,99999-7002-73,VANCOMYCIN IN NS ENEMA,42.0,21.0,10.5,27.72,16
NDC,99999-7003-89,"MIFEPRISTONE, ORAL, 200 MG",148.0,74.0,36.55,201.28,30
NDC,99999-7006-03,ACETYLCHOLINE INTRACORONARY KIT PLACEHOLDER FOR PYXIS,110.0,55.0,27.5,72.6,16